Provider Demographics
NPI:1881978914
Name:BOLTON, MARIA A (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:BOLTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8234 HIGHWAY 100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4043
Mailing Address - Country:US
Mailing Address - Phone:615-790-8047
Mailing Address - Fax:615-288-0933
Practice Address - Street 1:8234 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4043
Practice Address - Country:US
Practice Address - Phone:615-490-8047
Practice Address - Fax:615-288-0933
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000004059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist