Individual
JEFFERY MICHAEL BOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5145 RAWHIDE ST APT 167, LAS VEGAS, NV 89122-4806
(702) 372-4715
Mailing address
5145 RAWHIDE ST APT 167, LAS VEGAS, NV 89122-4806
(702) 372-4715
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/18/2013
Last updated
10/18/2013
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