Individual
MICHELLE BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 ALEXANDER RD, CAYCE, SC 29033-4378
(803) 518-6525
Mailing address
712 HENRY ST, EASTOVER, SC 29044
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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