Organization
LIFE CHANGE SPECIALTIES L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERARD-MAJELLA KOSKO DC (OWNER)
(717) 634-2398
Entity
Organization
Contact information
Practice address
439 EISENHOWER DR, HANOVER, PA 17331-5213
(717) 634-2398
(717) 634-2401
Mailing address
439 EISENHOWER DR, HANOVER, PA 17331-5213
(717) 634-2398
(717) 634-2401
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC008690
PA
Other
Enumeration date
07/14/2008
Last updated
09/15/2008
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