Provider Demographics
NPI:1891598066
Name:BOLIER, TAMMY (MT)
Entity type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:
Last Name:BOLIER
Suffix:
Gender:
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8529 LANSDALE RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-0103
Mailing Address - Country:US
Mailing Address - Phone:702-771-6632
Mailing Address - Fax:
Practice Address - Street 1:8529 LANSDALE RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-0103
Practice Address - Country:US
Practice Address - Phone:702-771-6632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3039225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist