Individual
BRENN ALINE BOLDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MS, LAT
Contact information
Practice address
3001 EDWARDS MILL RD STE 200, RALEIGH, NC 27612-5243
(919) 863-6856
Mailing address
3001 EDWARDS MILL RD, RALEIGH, NC 27612-5243
(919) 781-5600
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
0010-14785
NC
Other
Enumeration date
11/29/2017
Last updated
11/04/2024
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