Provider Demographics
NPI:1922278571
Name:BOLE, DAVID NELSON (PHD,AP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NELSON
Last Name:BOLE
Suffix:
Gender:M
Credentials:PHD,AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 NW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4153
Mailing Address - Country:US
Mailing Address - Phone:352-335-1975
Mailing Address - Fax:352-335-1077
Practice Address - Street 1:1204 NW 10TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4153
Practice Address - Country:US
Practice Address - Phone:352-335-1975
Practice Address - Fax:352-335-1077
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP117171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist