Individual
JOSHUA KYLE BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 COLISEUM DR, HAMPTON, VA 23666-5963
(757) 599-4922
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-3292
(239) 343-3695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-004270
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013228200
—
FL
Enumeration date
06/18/2013
Last updated
06/07/2022
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