| NPI Details | |
|---|---|
| NPI | 1073680088 |
| Enumeration Date | 11/29/2006 |
| Last Updated | 10/15/2010 |
| Entity Type | Healthcare Provider |
| Active | Over 11 years ago |
| Authorized Information | |
|---|---|
| Name | CHANNING C. CHANNING |
| Position | PRESIDENT |
| Phone | (407) 629-5333 |
| Fax | (407) 629-5343 |
| Practice Location | |
|---|---|
| 500 E HORATIO AVE SUITE 5 MAITLAND FL, 32751-7310, US |
|
| Phone | (407) 629-5333 |
| Fax | (407) 629-5343 |
| Business Location | |
|---|---|
| 500 E HORATIO AVE SUITE 5 MAITLAND FL, 32751-7310, US |
|
| Phone | (407) 629-5333 |
| Fax | (407) 629-5343 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 111N00000X |
| License State | Florida |
| License Number | CH7882 |
| Remove 1073680088 NPI Number | |
According to our database, The Bolick Clinic, Inc. NPI is 1073680088, taxonomy code is 111N00000X and license number is CH7882, license state is located at Florida. The Bolick Clinic, Inc. physically located at 500 E Horatio Ave, Maitland FL, 32751-7310. NPI Number 1033115704 has the healthcare provider type.
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1073680088 NPI number is provided on an as is basis without warranty of any kind. 1073680088 is maintained by the National Plan & Provider Enumeration System. The contents of The Bolick Clinic, Inc. are for informational purposes only.
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