Boldt, Randall E

Boldt, Randall E is an individual health care provider with primary practice located at 1008 W 35Th St , Davenport IA 52806-5827. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Boldt, Randall E can be contacted via phone (563) 324-2263.

Contact Information

Primary practice address
1008 W 35Th St Davenport IA 52806-5827
Phone: (563) 324-2263
Fax: (563) 324-0719
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 02562 Iowa
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070-008667 Illinois

Profile Details

NPI number 1043277155
LBN Legal business name Boldt, Randall E
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Sep 23rd, 2013 - about 12 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 1043277155 NPPES
Iowa Other 02562 IOWA PT LICENSE NUMBER
Iowa Other 070-008667 IOWA PT LICENSE NUMBER

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