Individual
KATHY BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1814 VICKERY RD, PORTAGE, MI 49002-7608
(269) 270-3175
Mailing address
1814 VICKERY RD, PORTAGE, MI 49002-7608
(269) 270-3175
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/26/2016
Last updated
06/01/2016
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