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Individual

JACOB BOLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1316 S MAIN ST, CLARION, IA 50525-2019
(515) 532-8211
(515) 532-3119
Mailing address
555 SW 7TH ST UNIT 7, DES MOINES, IA 50309-4532
(716) 307-6088

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
712697
NY
367500000X
Certified Registered Nurse Anesthetist
712697
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
D168676
IA

Other

Enumeration date
10/01/2021
Last updated
11/02/2023
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