Individual
BRYAN E BOLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
909 WILSON RD RM B119, EAST LANSING, MI 48824-6410
(517) 353-3070
(517) 884-1817
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015
(517) 353-3070
(517) 884-1817
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5101026250
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2019
Last updated
11/27/2023
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