NPI 1194909069

Richard C Boleware, CP

Practitioner Prosthetist Jackson, MS

Practice location

Address: 2 Old River Pl STE D, Jackson, MS 39202-3435
Phone: (601) 944-1130
Fax: (601) 355-7476

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence CP003226 (MS)

Other Prosthetist providers in Mississippi →

Registry record

NPI: 1194909069
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Dec 2007
Record last updated: 19 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.