Organization
BOLING VISION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CLAYTON BOLING II M.D. (OWNER)
(574) 293-3545
Entity
Organization
Contact information
Practice address
1615 WINSTED DR, GOSHEN, IN 46526-4696
(574) 533-9633
(574) 533-9314
Mailing address
2746 OLD US 20 W, ELKHART, IN 46514-1364
(574) 293-3545
(574) 522-0599
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/14/2007
Last updated
02/11/2008
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