Individual
DR. TERREN BURGESS KOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2912 SPRINGBORO RD, SUITE, MORAINE, OH 45439-1674
(513) 695-1468
(513) 695-2941
Mailing address
2912 SPRINGBORO RD, SUITE 201, MORAINE, OH 45439-1674
(937) 885-1927
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
35050061K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2933179
—
OH
Enumeration date
12/28/2006
Last updated
04/13/2012
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