Individual
JUSTINE MARIE PRIKOSOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, CNS
Contact information
Practice address
65250 SYCAMORE RD, NORTH LIBERTY, IN 46554-9086
(574) 303-9292
(574) 381-5414
Mailing address
PO BOX 233, SOUTH BEND, IN 46624-0233
(574) 303-9292
(574) 381-5414
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005026A
IN
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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