Individual
JODI L BOLLENBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-5318
(419) 291-6430
Mailing address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-5318
(419) 291-6430
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50001972
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070455
—
OH
Enumeration date
11/17/2005
Last updated
12/03/2012
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