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General NPI Number Information
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NPI Number | 1508130451
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Entity Type | Organization
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Legal Business Name | KOLA CHIROPRACTIC
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 04/12/2012
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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 | OWNER
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Name | DR. MATTHEW KOLA
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Credential | D.C.
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Telephone | 614-330-6235
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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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