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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