Individual
JASON R KOLODZIEJCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2311 HAYES AVE, FREMONT, OH 43420-2634
(419) 334-8121
(419) 332-9351
Mailing address
2311 W HAYES AVE, FREMONT, OH 43420
(419) 334-8121
(419) 332-9351
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
PENDING
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2677214
—
OH
Enumeration date
07/10/2006
Last updated
07/11/2012
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