Precious Laquon Bolden Valid NPI
Individual provider · Driver · Grand Prairie, TX
- NPI
- 1063020816
- Type
- Individual (Type 1)
- Primary specialty
- Driver
- Specialty group
- Other Service Providers
- Taxonomy code
- 172A00000X
- License number
- 45590009 (TX)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2020-07-17
- Last updated
- 2020-07-17
Practice location
1450 N State Highway 360 Apt 371
Grand Prairie, TX 75050-4108
(262) 751-0253