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Individual
MR. GRANT RYAN KOSTER
Active
Individual
MR. GRANT RYAN KOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MSPT, ATC, CSCS
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
096-001522
IL
225100000X
Physical Therapist
Primary
070012664
IL
Other
Enumeration date
03/14/2006
Last updated
02/24/2017
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