Bolak, Kevin John

Bolak, Kevin John is an individual health care provider with primary practice located at 3324 Glade St , Muskegon MI 49444-2708. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist, which is considered as his primary health care specialty. Bolak, Kevin John can be contacted via phone (231) 215-1419.

Contact Information

Primary practice address
3324 Glade St Muskegon MI 49444-2708
Phone: (231) 215-1419
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X CP002002 Delaware

Profile Details

NPI number 1942408471
LBN Legal business name Bolak, Kevin John
Credentials Certified Psychologist (CP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942408471 NPPES
Michigan Other 0F10293 BCBSM PROVIDER PIN

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