Individual
MR. THOMAS MCLEAN BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
417 E BALTIMORE ST, UNIT A, TANEYTOWN, MD 21787-2300
(410) 756-5240
Mailing address
417 E BALTIMORE ST, UNIT A, TANEYTOWN, MD 21787-2300
(410) 756-5240
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P03001
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12598
STATE PHARMACY LIC
MD
01
—
C22369
BOC ORTHOTIC/PROSTHET
MP
01
—
CFO02610
ABC IN ORTHOTICS/PROSTHET
MD
Enumeration date
08/30/2006
Last updated
07/08/2007
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