Individual
JOHN BOLENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 N 15TH AVE, HIAWATHA, IA 52233-2347
(319) 378-8583
Mailing address
4725 MERLE HAY RD, SUITE 107, DES MOINES, IA 50322-1983
(515) 331-3190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
081687
IA
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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