Individual
JILLIAN KOLSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4820 LUXEMBURG ST SE, GRAND RAPIDS, MI 49546-3742
(616) 915-2598
Mailing address
4820 LUXEMBURG ST SE, GRAND RAPIDS, MI 49546-3742
(616) 915-2598
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
K423414585184
MI
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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