Individual
BENJAMIN J KOLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3385 DEXTER CT STE 103, DAVENPORT, IA 52807-3471
(563) 441-5860
(563) 441-5865
Mailing address
3385 DEXTER CT STE 103, DAVENPORT, IA 52807-3471
(563) 441-5860
(563) 441-5865
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002418
IA
363A00000X
Physician Assistant
085.004768
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871934851
—
IA
Enumeration date
07/08/2013
Last updated
02/05/2015
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