Individual
MATTHEW KOESTERER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
746 URBANNA DR, FREEBURG, IL 62243-1904
(618) 539-5856
Mailing address
30 RIO VERDE DR, BELLEVILLE, IL 62221-3124
(618) 604-3508
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.006101
IL
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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