Individual
MS. MICHELLE RENEE KOSTELAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4760 UNION DEPOSIT ROAD, SUITE 100, HARRISBURG, PA 17111-3729
(717) 545-9811
(717) 545-9979
Mailing address
4760 UNION DEPOSIT ROAD, SUITE 100, HARRISBURG, PA 17111-3729
(717) 545-9811
(717) 545-9979
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053165
PA
Other
Enumeration date
01/05/2006
Last updated
08/17/2011
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