Individual
MR. TAMMIE LATISHA BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6642 68TH ST E, BRADENTON, FL 34203-9765
(941) 896-0611
(941) 567-0452
Mailing address
6642 68TH ST E, BRADENTON, FL 34203-9765
(941) 896-0611
(941) 567-0452
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
231506
FL
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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