Individual
TERRENCE CHRISTOPHER BOLGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1541 ANNEX ROAD, JEFFERSON, WI 53549
(920) 674-8799
(920) 674-2359
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-8799
(920) 674-2359
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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