Individual
CRYSTAL S BOLANOS-MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PT
Contact information
Practice address
3910 GOFORTH DR, HOPE MILLS, NC 28348-8529
(336) 324-8741
Mailing address
3910 GOFORTH DR, HOPE MILLS, NC 28348-8529
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P13978
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P13978
NC PT LICENSE NUMBER
NC
Enumeration date
01/12/2016
Last updated
01/12/2016
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