Individual
MR. GARY R BOLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CO
Contact information
Practice address
74 FAIRFIELD, FOOTHILL RANCH, CA 92610-1855
(949) 716-9091
(949) 916-9245
Mailing address
74 FAIRFIELD, FOOTHILL RANCH, CA 92610-1855
(949) 716-9091
(949) 916-9245
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CO3161
—
Other
Enumeration date
12/01/2006
Last updated
07/09/2007
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