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1750597779
MICAH BOLANDER
SAINT LOUIS, MO
NPI
1750597779
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MO 2006038245)
Enumeration Date
2007-05-15
Last Update Date
2007-07-08
Business Address
-- MICAH BOLANDER MPT
3520 CHOUTEAU AVE
SAINT LOUIS, MO 63103-2916
Phone number: 314-771-2100
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Mailing Address
-- MICAH BOLANDER MPT
849 LONGACRE APT. B
SAINT LOUIS, MO 63132-4737
Phone number:
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