MRS. Anita Boulom, PA-C
NPI #1184213555 in Janesville, Wisconsin
Provider Information
- NPI Number
- 1184213555
- Entity Type
- Individual
- Name
- MRS. Anita Boulom, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jan 11, 2021
- Last Updated
- Jan 11, 2021
Practice Location
- Address
- 3400 DEERFIELD DR
- City
- Janesville
- State
- Wisconsin
- ZIP Code
- 53546-3557
- Phone
- (608) 314-3600
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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