Individual
BROCK DEAN BOLDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
249 NW 71ST ST, OKLAHOMA CITY, OK 73116
(580) 369-0641
Mailing address
249 NW 71ST ST, OKLAHOMA CITY, OK 73116-5634
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6501
OK
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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