Individual
KRISTAN BOLDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15930 19 MILE RD, CLINTON TWP, MI 48038-1155
(586) 464-0175
Mailing address
54237 SURFSIDE DR, SHELBY TWP, MI 48316-1458
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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