STEPHEN BOLIVAR

LAUREL, MS
NPI1598199291
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  R888641)
Enumeration Date2013-08-29
Last Update Date2015-05-28
Business Address
-- STEPHEN BOLIVAR NP
235 S 14TH AVE
LAUREL, MS 39440-4227
Phone number: 601-651-2832
Mailing Address
-- STEPHEN BOLIVAR NP
235 S 14TH AVE
LAUREL, MS 39440-4227
Phone number: 601-651-2832
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