Individual
MISS LYLA ELIZABETH KOOISTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9615 KEILMAN ST, SAINT JOHN, IN 46373-9406
(219) 365-0228
(219) 365-0229
Mailing address
9615 KEILMAN ST, SAINT JOHN, IN 46373-9406
(219) 365-0228
(219) 365-0229
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006469A
IN
Other
Enumeration date
08/11/2026
Last updated
08/11/2026
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