Individual
MR. CHARLES EDWARD BOULDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.P.T.
Contact information
Practice address
4749 S EASON BLVD, SUITE A, TUPELO, MS 38801-6547
(662) 842-3336
(662) 842-3363
Mailing address
4749 S EASON BLVD, SUITE A, TUPELO, MS 38801-6547
(662) 842-3336
(662) 842-3363
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT0198
MS
Other
Enumeration date
03/22/2007
Last updated
11/08/2010
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