Provider Demographics
NPI:1861776106
Name:BOULD, JAMES W (DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:BOULD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:3001 EDWARDS MILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5243
Mailing Address - Country:US
Mailing Address - Phone:919-863-6856
Mailing Address - Fax:919-863-6821
Practice Address - Street 1:781 AVENT FERRY RD STE 110
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7776
Practice Address - Country:US
Practice Address - Phone:919-781-4060
Practice Address - Fax:919-781-5246
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2023-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC13369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist