Individual
BRENDA BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3395 STATE ROAD J, FULTON, MO 65251-3018
(573) 642-8126
Mailing address
3395 STATE ROAD J, FULTON, MO 65251-3018
(573) 642-8126
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01609
MO
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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