| Doctor Name: | BETSY JO BOLTON |
| NPI Number: | 1144574997 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 002351 |
| Business Practice Address: | 455 N Sioux Point Rd Dakota Dunes, SD - 570495327 |
| Business Phone Number: | 6052177000 |
| Business Fax Number: | 6052177015 |
| Mailing Address: | 455 N Sioux Point Rd, DAKOTA DUNES |
| State: | SD |
| Postal Code: | 570495327 |
| Phone Number: | 6052177000 |
| Fax Number: | 6052177015 |
| NPI Enumeration Date: | 11/01/2012 |
| NPI Last Update Date: | 11/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 002351 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |