Provider Demographics
NPI:1073944682
Name:BOLHA, KRISTY (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:BOLHA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 SE 6TH AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5208
Mailing Address - Country:US
Mailing Address - Phone:561-278-6055
Mailing Address - Fax:
Practice Address - Street 1:247 SE 6TH AVE
Practice Address - Street 2:STE 2
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5208
Practice Address - Country:US
Practice Address - Phone:561-278-6055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-07
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 26689225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist