Shannon Mary Bolger, ATC

NPI #1548615362 in Maple Glen, Pennsylvania

Provider Information

NPI Number: 1548615362
Entity Type: Individual
Name: Shannon Mary Bolger, ATC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: ATC
Enumeration Date: Apr 29, 2016
Last Updated: Apr 29, 2016

Practice Location

Address: 1700 LUDWELL DR
City: Maple Glen
State: Pennsylvania
ZIP Code: 19002-3027
Phone: (610) 724-1185

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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