Individual
GWENDOLYN BOLDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4615 WALZEM ROAD, 207, SAN ANTONIO, TX 78218
(210) 862-8211
Mailing address
7326 MYSTERY RDG, CONVERSE, TX 78109-2727
(210) 862-8211
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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