Kimberley Marie Bolog

NPI #1902639784 in Willoughby, Ohio

Provider Information

NPI Number: 1902639784
Entity Type: Individual
Name: Kimberley Marie Bolog
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Homemaker
Enumeration Date: Aug 26, 2024
Last Updated: Aug 26, 2024

Practice Location

Address: 1054 CHEROKEE TRL
City: Willoughby
State: Ohio
ZIP Code: 44094-7211
Phone: (440) 226-6114

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Homemaker	376J00000X	Primary

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