Provider Information for 1073009395
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LAINE KOLESAR LSW
Sex: Female
NPI: 1073009395
Last Updated: 2018-07-10
Certification Date:
Certification Date:
Details
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| NPI | 1073009395 | ||||||||
| Enumeration Date | 2018-07-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1304 DILLON AVE CINCINNATI, OH 45208-4209 United States Phone: 513-562-7534 | Fax: | ||||||||
| Primary Practice Address | 431 E BROAD ST COLUMBUS, OH 43215-4004 United States Phone: 614-885-5020 | Fax: | ||||||||
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