Individual
CARL KOTERWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT ATC
Contact information
Practice address
8203 VISTA COLORADO ST, LAS VEGAS, NV 89123-4312
(702) 289-1246
Mailing address
8203 VISTA COLORADO ST, LAS VEGAS, NV 89123-4312
(702) 289-1246
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0506379
NV
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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