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1689922403
AMANDA MICHELLE BOLIN
FORT WAYNE, IN
NPI
1689922403
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: IN 37002215A)
Enumeration Date
2012-08-28
Last Update Date
2012-11-05
Business Address
-- AMANDA MICHELLE BOLIN RD
11141 PARKVIEW PLAZA DR SUITE 210
FORT WAYNE, IN 46845-1713
Phone number: 260-347-8187
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Mailing Address
-- AMANDA MICHELLE BOLIN RD
1234 E. DUPONT RD. SUITE 1
FORT WAYNE, IN 46825-1545
Phone number: 260-373-9728
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