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MYRON BOLING

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1104022862

Individual Registrant:
 MYRON  BOLING 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
210 MANOR ST  MARION, AR 72364-1936 US
Tel: 870-739-6818  Fax: --

Contact information for business:
2902 SCOTCHWOOD DR  JONESBORO, AR 72401-8215 US
Tel: 870-273-2841  Fax: --

Registration Information:
NPI: 1104022862
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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