Individual
MR. RUSTON GEORGE BOLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
402 E MAIN ST, MONCKS CORNER, SC 29461
(843) 761-5255
Mailing address
PO BOX 528, ELLOREE, SC 29047
(803) 897-2303
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5423
SC
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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