Provider Demographics
NPI:1548621345
Name:BOLLINI, GIOVANNI
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:
Last Name:BOLLINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30180 PROGRESS ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4657
Mailing Address - Country:US
Mailing Address - Phone:586-588-0863
Mailing Address - Fax:
Practice Address - Street 1:30180 PROGRESS ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4657
Practice Address - Country:US
Practice Address - Phone:586-588-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor