Most Relevant Information
Provider Data
| NPI Number: | 1003305129 |
| Provider Name: | LARA KOLLAB DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/03/2018 |
| Last Updated: | 05/03/2018 |
Provider Practice Location
9500 EUCLID AVE # NA23
CLEVELAND
OH
441950001
Practice Location Phone/Fax
| Phone: | 2164442200 |
| Fax: |
Provider Mailing Location
9500 EUCLID AVE # NA23
CLEVELAND
OH
441950001
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |