Individual
MIRANDA BOLLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
580 TOMMY LEE FULLER DR, LOGANVILLE, GA 30052-3943
(888) 336-5033
Mailing address
580 TOMMY LEE FULLER DR, LOGANVILLE, GA 30052-3943
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006073
GA
Other
Enumeration date
11/13/2014
Last updated
11/13/2014
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