Bolton, Kyle

Bolton, Kyle is an individual health care provider with primary practice located at 20460 Anaconda Rd , Fort Drum NY 13603. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is his primary health care specialty. Bolton, Kyle can be contacted via phone (480) 387-0619.

Contact Information

Primary practice address
20460 Anaconda Rd Fort Drum NY 13603
Phone: (480) 387-0619
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X

Profile Details

NPI number 1861151326
LBN Legal business name Bolton, Kyle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2021
Last updated Mar 18th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers