Individual
MRS. JANINE M. BOLDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8155
Mailing address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8155
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1690-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40132300
—
WI
Enumeration date
04/06/2007
Last updated
03/06/2014
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