Individual
MISS CRISTINA MARIE KOSSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
235 S 33RD ST, PHILADELPHIA, PA 19104-6322
(215) 573-0554
Mailing address
235 S 33RD ST, PHILADELPHIA, PA 19104-6322
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007130
PA
Other
Enumeration date
02/10/2016
Last updated
05/28/2019
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