Individual
KEVIN BOLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5301 E GRANT RD, TUCSON, AZ 85712-2805
(520) 318-3434
Mailing address
265 MESA TRAIL DR, SIERRA VISTA, AZ 85635-4436
(858) 361-7198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
009034
AZ
Other
Enumeration date
06/12/2018
Last updated
02/18/2022
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