Individual
HEATHER LEE BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
177 N HIGHLAND ST, MEMPHIS, TN 38111-4747
(901) 325-4000
Mailing address
1316 ARMAND DR APT 201, MEMPHIS, TN 38103-8953
(865) 585-3816
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6410
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6410
STATE OF TENNESSEE
TN
Enumeration date
01/28/2019
Last updated
01/28/2019
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