Individual
MRS. TOMIE COSTERISAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
26 N MAIN ST, MIAMI, OK 74354-6323
(918) 542-8455
Mailing address
26 N MAIN ST, MIAMI, OK 74354-6323
(918) 542-8455
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1253
OK
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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