Individual
THOMAS E BOLZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC,LAT
Contact information
Practice address
201 JOHN GLENN DR, WALKERTON, IN 46574-1439
(574) 586-3195
Mailing address
1006 TYLER ST, WALKERTON, IN 46574-1448
(574) 849-7866
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001414A
IN
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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