Ricky Boldman

NPI #1437126323 in Pontiac, Michigan

Provider Information

NPI Number
1437126323
Entity Type
Individual
Name
Ricky Boldman
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Enumeration Date
Mar 1, 2006
Last Updated
Jul 16, 2007

Practice Location

Address
461 W HURON ST
Address 2
SUITE 207
ZIP Code
48341-1601
Phone
(248) 857-7160

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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