Individual
DR. JACOB EDWARD BOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
25 JEFFERSON RIVER RD, THREE FORKS, MT 59752-9765
(712) 260-0831
Mailing address
25 JEFFERSON RIVER RD, THREE FORKS, MT 59752-9765
(712) 260-0831
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH60706123
WA
111N00000X
Chiropractor
Primary
CHI-CHI-LIC-4595
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437668449
—
MT
Enumeration date
11/18/2016
Last updated
07/21/2022
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