Individual
IAN MICHAEL KOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6100 LAKE FORREST DR STE 320, ATLANTA, GA 30328-3835
(404) 255-6027
(404) 255-4858
Mailing address
6100 LAKE FORREST DR STE 320, ATLANTA, GA 30328-3835
(404) 255-6027
(404) 255-4858
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010387
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHIR010387
LICENSE NUMBER
GA
Enumeration date
09/21/2020
Last updated
09/21/2020
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