Individual
MR. JESSE ANDREW KOLODZIEJSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1400 COLEMAN AVE, MACON, GA 31207-0001
(478) 301-2371
(478) 301-2039
Mailing address
1400 COLEMAN AVE, MACON, GA 31207-0001
(478) 301-2371
(478) 301-2039
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000003945
MD
Other
Enumeration date
07/13/2010
Last updated
07/13/2010
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