Individual provider · Type 1 NPI

Krista D. Bolanger, PA

Medical Physician Assistant · Dayton, OH

NPI number 1073651337 Active

Practice location

9000 N Main St, Suite 227
Dayton, OH 45415-1180

Fax (937) 832-2986

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X50 002179 (OH)

Medical Physician Assistant: Definition to come...

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About NPI 1073651337

Krista D. Bolanger, PA's National Provider Identifier is 1073651337, issued on Feb 1, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Dayton, OH. The record was last updated on Oct 23, 2018.