Individual
DANIEL CODY LOLLATHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
515 UNION AVE, SUITE 167, DOVER, OH 44622-3004
(330) 343-3335
Mailing address
11 LAKEVIEW CT, BIDWELL, OH 45614-9004
(740) 612-9094
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004991RX
OH
Other
Enumeration date
02/11/2017
Last updated
02/11/2017
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