Individual
MISS ANNA NICOLE KOSTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
0119005513
VA
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
Update your record
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