Individual
TRAVIS BOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
78 W WASHINGTON ST, NELSONVILLE, OH 45764-1135
(513) 470-7056
Mailing address
95 CIRCLE DR APT 8, FLORENCE, KY 41042-2432
(859) 380-7102
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
1187506
KY
175T00000X
Peer Specialist
Primary
APS.005878
OH
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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