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Individual

MISS ANNA NICOLE KOSTAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
693 LEESVILLE RD, LYNCHBURG, VA 24502-2828
(434) 200-5750
(434) 200-1662
Mailing address
693 LEESVILLE RD, LYNCHBURG, VA 24502-2828
(434) 200-1662

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
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