MR. Richard C Boleware, CP

NPI #1194909069 in Jackson, Mississippi

Provider Information

NPI Number: 1194909069
Entity Type: Individual
Name: MR. Richard C Boleware, CP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Prosthetist
Credential: CP
Enumeration Date: Dec 27, 2007
Last Updated: May 19, 2015

Practice Location

Address: 2 OLD RIVER PL STE D
City: Jackson
State: Mississippi
ZIP Code: 39202-3435
Phone: (601) 944-1130

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prosthetist	224P00000X	Primary

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