Individual
JEREMY E BOLLUYT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2700 23RD ST, SUITE C, SPIRIT LAKE, IA 51360-1158
(712) 336-3750
(712) 336-3730
Mailing address
2700 23RD ST, SUITE C, SPIRIT LAKE, IA 51360-1158
(712) 336-3750
(712) 336-3730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3326
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1187948
—
IA
Enumeration date
01/26/2006
Last updated
11/06/2007
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