Individual
GEORGE BOLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
835 W JOHNSON ST, SPC. C07C FOREST MALL, FOND DU LAC, WI 54935-8297
(920) 906-9489
Mailing address
161 LAKE SHORE TER, BEAVER DAM, WI 53916-1245
(920) 887-2864
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1570-035
WI
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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