Individual
CARLYE BOLSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3703 HARRISON AVE STE B, BUTTE, MT 59701-6897
(406) 565-5730
(405) 565-5734
Mailing address
3703 HARRISON AVE STE B, BUTTE, MT 59701-6897
(406) 565-5730
(406) 565-5734
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MED-PAC-LIC-68538
MT
363AM0700X
Medical Physician Assistant
PA159424
OR
Other
Enumeration date
12/21/2010
Last updated
08/29/2019
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