Individual
KEVIN MICHAEL KOTSKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
205 SHELL BLDG, MORGANTOWN, WV 26507
(304) 293-3309
Mailing address
763 FAIRMONT RD, A6, MORGANTOWN, WV 26501-3800
(304) 216-3479
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06952435
NATABOC CERTIFICATION NUM
—
Enumeration date
06/15/2007
Last updated
07/08/2007
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