Bolger Aesthestics, PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

BOLGER AESTHESTICS, PC

Doing business as

Medical Aesthetics and Wellness Center

Practice address

5510 Utica Ridge Rd
Suite 300
Davenport, IA 52807-2946

Phone

(563) 355-4813

Fax

(563) 594-5161

NPI assigned

Dec 30, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul Bolger, MDNPI 1376516609

Title

Owner

Phone

(563) 355-4813

Specialties & licenses 1

Addresses

Other names 1

• Medical Aesthetics and Wellness Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Bolger

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1376516609
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1124449780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 UTICA RIDGE RD",
            "address_2": "SUITE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072946",
            "telephone_number": "563-355-4813",
            "fax_number": "563-594-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 UTICA RIDGE RD",
            "address_2": "SUITE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072946",
            "telephone_number": "563-355-4813",
            "fax_number": "563-594-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLGER AESTHESTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-30",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "BOLGER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-355-4813",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Aesthetics and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynn Marie Boelger, D.C.
• Ronnie J. Boesch, D.C.
• Margaret Jean Bohnert, OT
• Lillia Bolboli
• Randall E Boldt, PT
• James Randall Bolton, LISW
• Prakash R Bontu, M.D.
• Rupa Bontu, MD
• Amanda Lynn Boone, PHARMD
• Jacob Bradley Boraas, DC

• Health Service Clinic/Center in Davenport, IA
• Providers in Davenport, IA by specialty
• Health Service Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.