Provider Demographics
NPI:1265861694
Name:KOLASINSKI, PETER (LPTA)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:KOLASINSKI
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 STACEY LN
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-2429
Mailing Address - Country:US
Mailing Address - Phone:419-509-3585
Mailing Address - Fax:
Practice Address - Street 1:7120 PORT SYLVANIA DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1158
Practice Address - Country:US
Practice Address - Phone:419-843-7437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant