Individual
EVELYN KOSSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1701 SHARP RD, WATERFORD, WI 53185-5214
(262) 534-7297
Mailing address
1701 SHARP RD, WATERFORD, WI 53185-5214
(262) 534-7297
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4250-019
WI
Other
Enumeration date
05/05/2025
Last updated
05/05/2025
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