William Spencer Bolt, PA-C Valid NPI

Individual provider · Physician Assistant · Jellico, TN

NPI

1891402103

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

5238 (TN)

Sex

Male

Sole proprietor

No

Enumerated

2022-11-04

Last updated

2022-11-04