| Doctor Name: | MRS. CAROL ANN BOLT |
| NPI Number: | 1265468425 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 000102439 |
| Business Practice Address: | 551 Tucker St Craig, CO - 816251909 |
| Business Phone Number: | 9708241976 |
| Business Fax Number: | |
| Mailing Address: | 551 Tucker St, CRAIG |
| State: | CO |
| Postal Code: | 816251909 |
| Phone Number: | 9708241976 |
| Fax Number: | |
| NPI Enumeration Date: | 06/22/2006 |
| NPI Last Update Date: | 10/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 000102439 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |