Individual
MARY D BOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
310 N CLIPPERT ST, STE 4, LANSING, MI 48912-4694
(517) 332-1691
(517) 324-0210
Mailing address
3945 OKEMOS RD, STE B1, OKEMOS, MI 48864-4207
(517) 349-0200
(517) 349-3030
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000086
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540C312880
BCBS HEARING AIDS
MI
01
—
640C326130
BCBS SERVICES
MI
05
—
804679861
—
MI
Enumeration date
08/13/2006
Last updated
05/27/2014
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