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General NPI Number Information
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NPI Number | 1346512977
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Entity Type | Individual
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Provider Name | MATTHEW KOLA D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2012
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 410 BUNTY STATION RD
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City | DELAWARE
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State | OH
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Zip | 43015-7970
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Country | US
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Telephone | 740-417-9450
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Fax | 740-417-9451
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Provider Business Mailing Address
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Address Line | 410 BUNTY STATION RD.
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City | DELAWARE
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State | OH
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Zip | 43015-7970
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Country | US
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Telephone | 740-417-9450
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Fax | 740-417-9451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4111
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 4111
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License Number State | OH
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