Individual
EDDIE BOLES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 460-5242
Mailing address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 460-5242
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
07/27/2023
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