Provider Demographics
NPI:1093918294
Name:BOLIN, ALLEN R (DC)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:R
Last Name:BOLIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 0005
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-1260
Mailing Address - Country:US
Mailing Address - Phone:252-459-1110
Mailing Address - Fax:252-459-6523
Practice Address - Street 1:343 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-1260
Practice Address - Country:US
Practice Address - Phone:252-459-1110
Practice Address - Fax:252-459-6523
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3709111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor