Organization
EAST INDIANA RECOVERY, LLC
Active
Organization
EAST INDIANA RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KOLODZIK MD (OWNER)
(937) 825-6220
Entity
Organization
Contact information
Practice address
1528 NW 5TH ST, RICHMOND, IN 47374-1844
(937) 416-5442
(765) 935-0073
Mailing address
117 S DIXIE DR STE 3, VANDALIA, OH 45377-2142
(937) 416-5442
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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