Individual
REBECCA BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1170 PEACHTREE ST NE STE 1200, ATLANTA, GA 30309-7673
(901) 355-2793
Mailing address
47 AUTUMN PL, POWDER SPRINGS, GA 30127-5143
(901) 355-2793
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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