Provider Demographics
NPI:1033201900
Name:BOLLING, JOANN (DC)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:BOLLING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:GREENSAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3803 HWY 6 SOUTH
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-4317
Mailing Address - Country:US
Mailing Address - Phone:281-752-7173
Mailing Address - Fax:281-752-8187
Practice Address - Street 1:3803 HWY 6 SOUTH
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-4317
Practice Address - Country:US
Practice Address - Phone:281-752-7173
Practice Address - Fax:281-752-8187
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6044111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
603819Medicare ID - Type Unspecified
U39632Medicare UPIN