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1174191399
ISAAC JAMES KOLODITCH
WINSTON SALEM, NC
NPI
1174191399
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-06-14
Last Update Date
2021-06-14
Business Address
ISAAC JAMES KOLODITCH
475 VINE ST
WINSTON SALEM, NC 27101-4135
Phone number: 941-761-0409
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Mailing Address
ISAAC JAMES KOLODITCH
912 MADISON AVE
WINSTON SALEM, NC 27103-4542
Phone number: 941-716-0409
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