Individual
AIVARS VITOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4160 LITTLE YORK RD, SUITE 10, DAYTON, OH 45414-5800
(937) 415-9100
Mailing address
PO BOX 713130, CINCINNATI, OH 45271-0001
(937) 415-9100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
34-00-2091
OH
207X00000X
Orthopaedic Surgery Physician
Primary
002091
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0300436
—
OH
01
—
P01216000
RR MEDICARE
OH
Enumeration date
01/20/2006
Last updated
10/28/2013
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