MEDICARE: MR. JAMES PAUL BOLIN ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283X00000X	Rehabilitation Hospital	AT 214	AR

General Provider Information

NPI Number	:	1730208356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES PAUL BOLIN ATC

Provider Business Mailing Address
First Line	:	203 VALE ST
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-8134
Country	:	US
Telephone Number	:	501-282-0912
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 PROSPECT AVE
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-4003
Country	:	US
Telephone Number	:	501-622-3334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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