Individual
MR. JONATHAN OZIEL BOLANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
864 CENTRAL BLVD, BROWNSVILLE, TX 78520-7551
(956) 280-5491
Mailing address
864 CENTRAL BLVD, BROWNSVILLE, TX 78520-7551
(956) 280-5491
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2156995
TX
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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