Individual
MICHELLE LOSTRACCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4091 STATE HIGHWAY 6 S STE B, COLLEGE STATION, TX 77845-9476
(979) 690-2478
Mailing address
4091 STATE HIGHWAY 6 S STE B, COLLEGE STATION, TX 77845-9476
(979) 690-2478
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4050931
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4050931
TEXAS
TX
Enumeration date
09/16/2013
Last updated
09/16/2013
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