Provider Demographics
NPI:1508314105
Name:BOLAND, CINDY (L AC, MSTOM, DIPOM)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:BOLAND
Suffix:
Gender:F
Credentials:L AC, MSTOM, DIPOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3343 SOUTHGATE CT SW
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-5421
Mailing Address - Country:US
Mailing Address - Phone:319-432-6857
Mailing Address - Fax:
Practice Address - Street 1:3343 SOUTHGATE CT SW
Practice Address - Street 2:SUITE 105
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-5421
Practice Address - Country:US
Practice Address - Phone:319-432-6857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-97171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist