Individual
MR. DAVID THEODORE KOLOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
4 JOSEPH LN, ESSEX JUNCTION, VT 05452-2273
(802) 343-6503
Mailing address
4 JOSEPH LN, ESSEX JUNCTION, VT 05452-2273
(802) 343-6503
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000134
VT
Other
Enumeration date
11/19/2010
Last updated
11/19/2010
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