Individual
RACHEL KOOISTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8901 W LINCOLN AVE FL 1, WEST ALLIS, WI 53227-2409
(414) 329-5656
Mailing address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 329-5656
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4507-23
WI
Other
Enumeration date
10/03/2018
Last updated
12/02/2021
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