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Charles Bouldin, R.P.T
NPI 1679690101 · on the registry since 2007 · sole proprietor
Practice
- Address
- 4749 S Eason Blvd
Suite A
Tupelo, MS 38801 - Phone
- (662) 842-3336
- Fax
- (662) 842-3363
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- Specialist
174400000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-11-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi