Provider Demographics
NPI:1689414542
Name:BOLINGER, COLTON (DPT)
Entity type:Individual
Prefix:
First Name:COLTON
Middle Name:
Last Name:BOLINGER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 GYPSUM DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-3307
Mailing Address - Country:US
Mailing Address - Phone:641-344-9635
Mailing Address - Fax:
Practice Address - Street 1:1515 LINDEN ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3120
Practice Address - Country:US
Practice Address - Phone:515-288-0569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist