Individual
DR. DIANA LOWRY KOSLOWSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
511 WILSON AVE NW, SUITE G, GRAND RAPIDS, MI 49534-7986
(616) 301-8663
(616) 301-2987
Mailing address
511 WILSON AVE NW, SUITE G, GRAND RAPIDS, MI 49534-7986
(616) 301-8663
(616) 301-2987
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003577
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203516664
TAX ID
MI
01
—
900D115230
BCBS OF MICHIGAN
MI
Enumeration date
09/14/2005
Last updated
05/20/2008
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