Individual
MR. CODY SCOTT BOLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
4490 E UNIVERSITY AVE, GEORGETOWN, TX 78626-7877
(512) 943-1800
Mailing address
414 THUNDERBAY DR, GEORGETOWN, TX 78626-6305
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4099
TX
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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