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Individual

MS. CHERYL COLEGROVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
332 CONGRESS PARK DR, DAYTON, OH 45459-4133
(800) 726-3627
Mailing address
332 CONGRESS PARK DR, DAYTON, OH 45459-4133
(800) 726-3627

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50000763
OH
363AS0400X
Surgical Physician Assistant
50-000763
OH

Other

Enumeration date
05/02/2007
Last updated
08/27/2015
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