Individual
COLE MELSA TOMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-9355
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-9355
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
04/10/2023
Last updated
07/12/2023
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