Individual
MR. MARC BOLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
104 N 2ND ST, FORT PIERCE, FL 34950-4403
(772) 812-9824
Mailing address
221 NW FERRIS DR, PORT SAINT LUCIE, FL 34983-1120
(772) 812-9824
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
4808
FL
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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