Individual
RUTH E KOHSTALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
75 SYLVANIA DR, BEAVERCREEK, OH 45440-3237
(937) 320-5050
(937) 320-5060
Mailing address
75 SYLVANIA DR, BEAVERCREEK, OH 45440-3237
(937) 320-5050
(937) 320-5060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.001987RX
OH
363A00000X
Physician Assistant
50001987
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0092718
—
OH
Enumeration date
02/23/2006
Last updated
08/24/2020
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