Provider Demographics
NPI:1144063975
Name:BOLTON, RACHEL ELIZABETH (LAC, DIPLAC, MACOM)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:BOLTON
Suffix:
Gender:F
Credentials:LAC, DIPLAC, MACOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HARTFORD LN APT A
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-1937
Mailing Address - Country:US
Mailing Address - Phone:508-505-0533
Mailing Address - Fax:
Practice Address - Street 1:29 RIVERSIDE ST UNIT B
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1396
Practice Address - Country:US
Practice Address - Phone:603-880-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH358171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist