Individual
COLE D STATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
55 STONESTHROW CT, ALEXANDRIA, OH 43001-8779
(614) 402-1869
(888) 329-6432
Mailing address
55 STONESTHROW CT, ALEXANDRIA, OH 43001-8779
(614) 402-1869
(888) 329-6432
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85751
CSFA CERT#
—
Enumeration date
02/27/2007
Last updated
12/17/2019
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