Individual
SARA E VANDERKOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2325 18TH ST STE 220, COLUMBUS, IN 47201-5389
(812) 376-5640
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004154A
IN
Other
Enumeration date
07/06/2022
Last updated
01/24/2025
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