Individual
JACQUELINE KOSSOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
555 ANTHONY WAYNE TRL, WATERVILLE, OH 43566-1516
(419) 878-3901
Mailing address
6501 BRIXTON RD, MAUMEE, OH 43537-1102
(419) 708-6295
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/22/2007
Last updated
03/18/2013
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