Organization
WOODMAN PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY F KOLACZKOWSKI MSW (DIRECTOR)
(937) 272-5926
Entity
Organization
Contact information
Practice address
1320 WOODMAN DR, DAYTON, OH 45432-3497
(937) 223-1781
(937) 424-8656
Mailing address
1320 WOODMAN DR, DAYTON, OH 45432-3497
(937) 223-1781
(937) 424-8656
Taxonomy
Speciality
Code
Description
License number
State
2083T0002X
Medical Toxicology (Preventive Medicine) Physician
Primary
36D2087191
OH
Other
Enumeration date
02/01/2018
Last updated
02/01/2018
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