Individual
ALEX BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4645 TIGER LILY TRL, CLARKSTON, MI 48346-4982
(248) 882-2273
Mailing address
4645 TIGER LILY TRL, CLARKSTON, MI 48346-4982
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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