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Individual

SCOTT BOLESTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
190 WELLES ST STE 128, FORTY FORT, PA 18704-4961
(570) 714-6643
Mailing address
105 WAKEFIELD RD, SHAVERTOWN, PA 18708-9312

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RP045571L
PA

Other

Enumeration date
09/25/2017
Last updated
09/25/2017
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