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General NPI Number Information
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NPI Number | 1154275386
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Entity Type | Organization
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Legal Business Name | ND MEDICAL LLC
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 6694 TAYLOR RD
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City | CLINTON
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State | OH
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Zip | 44216-9201
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Country | US
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Telephone | 330-825-5202
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Fax | 330-825-5113
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Provider Business Mailing Address
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Address Line | 6694 TAYLOR RD
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City | CLINTON
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State | OH
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Zip | 44216-9201
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Country | US
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Telephone | 330-825-5202
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Fax | 330-825-5113
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Authorized Official
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Title or Position | CEO
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Name | ROBERT W BOLOIS
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Credential |
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Telephone | 330-825-5202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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