Most Relevant Information
Provider Data
| NPI Number: | 1003646449 |
| Provider Name: | MICHELLE RENEE BOLLING |
| Entity Type: | Individual |
| Taxonomy Code: | 261QA0600X |
| Specialty: | Clinic/Center |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/01/2024 |
| Last Updated: | 08/19/2024 |
Provider Practice Location
4260 FORT HENRY DR STE 18
KINGSPORT
TN
376632248
Practice Location Phone/Fax
| Phone: | 4234061200 |
| Fax: |
Provider Mailing Location
4009 LAKE FOREST DR
KINGSPORT
TN
376633773
Provider Mailing Phone/Fax
| Phone: | 4237826160 |
| Fax: |