Provider Demographics
NPI:1790017564
Name:BOLTON, JAMES (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:BOLTON
Suffix:
Gender:M
Credentials:DC, MS
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 9060
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27895-9060
Mailing Address - Country:US
Mailing Address - Phone:563-505-6464
Mailing Address - Fax:
Practice Address - Street 1:2801 WARD BLVD
Practice Address - Street 2:STE 7A
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-1752
Practice Address - Country:US
Practice Address - Phone:563-505-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor