Individual
CHARLES J BOLTINHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPED
Contact information
Practice address
615 B SOUTH MEMORIAL DRIVE, GREENVILLE, NC 27834
(252) 752-0338
Mailing address
615 B SOUTH MEMORIAL DRIVE, GREENVILLE, NC 27834
(252) 752-0338
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20732
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7795222
—
NC
Enumeration date
09/21/2006
Last updated
07/08/2007
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