Individual
IZAAK COSCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
12139 MANCHESTER RD, DES PERES, MO 63131-4310
(202) 039-4743
Mailing address
1222 LUCAS AVE APT 510, SAINT LOUIS, MO 63103-1942
(203) 947-4316
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2023003589
MO
Other
Enumeration date
11/14/2024
Last updated
11/14/2024
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