Doctor Name: | MR. JOE D BOLES |
NPI Number: | 1013228063 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | OH2761 |
Business Practice Address: | 3864 Center Rd Ste A2 Brunswick, OH - 442126600 |
Business Phone Number: | 3302256800 |
Business Fax Number: | 3302259911 |
Mailing Address: | 3864 Center Rd Ste A2, BRUNSWICK |
State: | OH |
Postal Code: | 442126600 |
Phone Number: | 3302256800 |
Fax Number: | 3302259911 |
NPI Enumeration Date: | 06/24/2010 |
NPI Last Update Date: | 06/24/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | OH2761 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |