Individual
ELLE KOSCIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
309 N BARTLETT ST, SHAWANO, WI 54166-2127
(715) 526-2111
Mailing address
1128 MISTLETOE LN, WINNECONNE, WI 54986-9625
(920) 573-9627
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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