Individual
SHANNON KOSMATKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2406 HARTLAND RD, WOODSTOCK, IL 60098-9763
(815) 338-0412
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006377
IL
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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