Individual
JOSEPHINE FRANCES COLLACO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1050 ISAAC STREETS DR, SUITE 104, OREGON, OH 43616-3291
(419) 698-4642
(419) 698-8597
Mailing address
1050 ISAAC STREETS DR, SUITE 104, OREGON, OH 43616-3291
(419) 698-4642
(419) 698-8597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
038665
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0303942
—
OH
Enumeration date
01/03/2006
Last updated
07/09/2007
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