Provider Demographics
NPI:1336549849
Name:BOLORIN, AMARILEES (ATC)
Entity Type:Individual
Prefix:
First Name:AMARILEES
Middle Name:
Last Name:BOLORIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 OXFORD LN
Mailing Address - Street 2:APT 202
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-1930
Mailing Address - Country:US
Mailing Address - Phone:413-275-4719
Mailing Address - Fax:
Practice Address - Street 1:816 OXFORD LN
Practice Address - Street 2:APT 202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-1930
Practice Address - Country:US
Practice Address - Phone:413-275-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer