Individual
MICHAEL KOSTESKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
710 FRANKLIN ST, SUITE 100, MICHIGAN CITY, IN 46360-3563
(219) 873-7037
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31003144A
IN
Other
Enumeration date
08/10/2006
Last updated
12/19/2007
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