Individual
AUSTIN RICHARD BOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NRP
Contact information
Practice address
1900 SOUTH AVE, LA CROSSE, WI 54601-5467
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5869
WI
Other
Enumeration date
03/20/2021
Last updated
09/14/2022
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