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General NPI Number Information
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NPI Number | 1316346414
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Entity Type | Organization
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Legal Business Name | GEORGIABOLTON
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 202 TORRINGTON DR
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City | TOLEDO
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State | OH
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Zip | 43615-5431
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Country | US
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Telephone | 419-531-8439
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Fax |
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Provider Business Mailing Address
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Address Line | 6126 WELSFORD CT
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City | MAUMEE
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State | OH
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Zip | 43537-1329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INDEPENDENT HOME HEALTH CARE
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Name | MRS. GEORGIA BOLTON
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Credential |
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Telephone | 419-283-1850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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