Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 282 | WV |
N | 111N00000X | Chiropractor | DC001905L | PA |
N | 111N00000X | Chiropractor | S01129 | MD |
N | 111NR0400X | Rehabilitation Chiropractor | 282 | WV |
N | 111NR0400X | Rehabilitation Chiropractor | DC001905L | PA |
N | 111NR0400X | Rehabilitation Chiropractor | S01129 | MD |
NPI | 1376693465 |
---|---|
Provider Name | Dr. David Lee Bolinger |
First Address | Oakland, MD 21550-1158 |
Second Address | Oakland, MD 21550-1158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 08/07/2007 |