Individual
DR. ELISE R BOLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
833 E 33RD ST, EDMOND, OK 73013-5407
(405) 216-5508
Mailing address
1420 COFFEY DR, PERRY, OK 73077-5807
(405) 250-6815
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2765
OK
Other
Enumeration date
08/09/2013
Last updated
08/09/2013
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