Provider Demographics
NPI:1740032275
Name:COLDSNOW, AUSTIN LOUIS (MSPAS)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:LOUIS
Last Name:COLDSNOW
Suffix:
Gender:M
Credentials:MSPAS
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Mailing Address - Street 1:4620 BRIAR HILL DR
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-7846
Mailing Address - Country:US
Mailing Address - Phone:330-592-4604
Mailing Address - Fax:
Practice Address - Street 1:1790 GRAYBILL RD STE 200
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7993
Practice Address - Country:US
Practice Address - Phone:234-312-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant