Individual
DANA MICHELLE BOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
12114 VENICE BLVD, LOS ANGELES, CA 90066-3812
(310) 397-6001
Mailing address
859 25TH ST, SANTA MONICA, CA 90403-2107
(213) 400-7700
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
11902
CA
Other
Enumeration date
01/22/2008
Last updated
01/22/2008
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