Individual
DAVID JOSEPH KUSTRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2600 MOREHOUSE AVE, ELKHART, IN 46517-2552
(574) 295-8800
Mailing address
59568 RIDGEWOOD DR, GOSHEN, IN 46528-9059
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003421A
IN
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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