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General NPI Number Information
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NPI Number | 1386642080
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Entity Type | Organization
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Legal Business Name | COLE CENTER FOR HEALING, INC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 04/11/2012
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Provider Practice Location Address
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Address Line | 7760 UNIVERSITY CT STE C
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City | WEST CHESTER
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State | OH
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Zip | 45069-3371
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Country | US
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Telephone | 513-563-4321
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Fax | 513-847-1017
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Provider Business Mailing Address
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Address Line | 7760 UNIVERSITY CT SUITE C
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City | WEST CHESTER
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State | OH
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Zip | 45069-3371
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Country | US
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Telephone | 513-563-4321
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Fax | 513-847-1017
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. THEODORE J COLE
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Credential | D.O
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Telephone | 513-563-4321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34004375C
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License Number State | OH
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