Individual
MR. KAMIL DOSTALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1135 N COMMERCIAL AVE, SAINT CLAIR, MO 63077-1012
(636) 629-8110
(636) 583-8960
Mailing address
20 STABLESTONE DR, UNION, MO 63084-4417
(636) 629-8110
(636) 583-8960
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02070
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
483847208
—
MO
Enumeration date
05/13/2007
Last updated
07/08/2007
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