Individual
JASON BOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
4166 JIMMY LEE SMITH PKWY, HIRAM, GA 30141-2647
(470) 272-0300
Mailing address
317 SMOKERISE CIR SE, MARIETTA, GA 30067-5479
(470) 272-0300
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002851
GA
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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