Individual
JEFFERY LY BOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
45 COLONIAL DR UNIT D, MONROE, LA 71203-2567
(318) 450-7022
(318) 450-3947
Mailing address
45 COLONIAL DR UNIT D, MONROE, LA 71203-2567
(318) 450-7022
(318) 450-3947
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
005026524
LA
Other
Enumeration date
11/03/2013
Last updated
11/03/2013
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