Provider Demographics
NPI:1184947780
Name:BOLIN, ERIN LEIGH (ATC, LAT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LEIGH
Last Name:BOLIN
Suffix:
Gender:F
Credentials:ATC, LAT
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 70
Mailing Address - Street 2:
Mailing Address - City:ARP
Mailing Address - State:TX
Mailing Address - Zip Code:75750-0070
Mailing Address - Country:US
Mailing Address - Phone:903-859-4917
Mailing Address - Fax:
Practice Address - Street 1:#1 TONEY DRIVE
Practice Address - Street 2:
Practice Address - City:ARP
Practice Address - State:TX
Practice Address - Zip Code:75750
Practice Address - Country:US
Practice Address - Phone:903-859-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT37692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer