Cynthia Ann Bolling, LPTA
Individual provider Active NPI Physical Therapy Assistant · Grand Haven, MI
NPI 1093487639 · NPPES record last updated Oct 1, 2021
Key facts
- NPI
- 1093487639
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5502004289 (MI)
- Practice address
- 900 S Beacon Blvd
Grand Haven, MI 49417-2146 - Phone
- (616) 296-7300
- NPI assigned
- Oct 1, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502004289 | MI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502004289 | MI | Yes |
Addresses
Primary practice location
900 S Beacon Blvd
Grand Haven, MI 49417-2146
Mailing address
15643 Littlefield LN
Spring Lake, MI 49456-1129
Phone (616) 340-2345
Other providers in Grand Haven, MI
- Andrew Michael Bobian
- Samantha Rachel Bock
- Karen Boeve
- Norman Russell Boeve
- Keegan Bohn
- Shawn C Bonner
- Nicholas Michael Bontumasi
- Ashley Bookmyer
- Daniela Borecky
- Evelyn Bosman
All providers in Grand Haven, MI · Physical Therapy Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.