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Individual

DR. JACQUELYN LISA KOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
999 FOXON RD, UNITE 8, NORTH BRANFORD, CT 06471
(203) 484-7579
(203) 484-2686
Mailing address
999 FOXON RD, UNITE 8, NORTH BRANFORD, CT 06471
(203) 484-7579
(203) 484-2686

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CT000885
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050000885CT04
ANTHEM
CT
05
4112710
CT
01
532967
AETNA
CT
01
760513
CTCARE OUT OF NETWORK
CT
01
948313
HEALTHNET
CT
01
P122567
OXFORD
CT
Enumeration date
08/22/2006
Last updated
07/08/2007
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