Individual provider · Type 1 NPI
Charles Edward Bouldin, R.P.T.
Specialist · Tupelo, MS
NPI number
1679690101
Active
Practice location
4749 S Eason Blvd, Suite A
Tupelo, MS 38801-6547
Fax (662) 842-3363
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | PT0198 (MS) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Another provider at this address
Other specialist providers in Tupelo
About NPI 1679690101
Charles Edward Bouldin, R.P.T.'s National Provider Identifier is 1679690101, issued on Mar 22, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Tupelo, MS. The record was last updated on Nov 8, 2010.