Organization
MIDWEST ALLERGY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI KNISLEY (OFFICE MANAGER)
(614) 846-5944
Entity
Organization
Contact information
Practice address
6275 E BROAD ST STE 100, COLUMBUS, OH 43213-1504
(614) 759-4730
(614) 759-4731
Mailing address
8080 RAVINES EDGE CT STE 100, COLUMBUS, OH 43235-5424
(614) 846-5944
(614) 846-6504
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064258
—
OH
Enumeration date
03/12/2020
Last updated
03/12/2020
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