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General NPI Number Information
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NPI Number | 1578686283
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Entity Type | Individual
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Provider Name | MICHAEL VINCENT BOLTON CO
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 350 NORTHERN BLVD SUITE 101
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City | ALBANY
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State | NY
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Zip | 12204-1000
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Country | US
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Telephone | 518-472-1023
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Fax | 518-472-1024
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Provider Business Mailing Address
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Address Line | 350 NORTHERN BLVD SUITE 101
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City | ALBANY
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State | NY
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Zip | 12204-1000
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Country | US
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Telephone | 518-472-1023
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Fax | 518-472-1024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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