Individual
CHRISTAN MICHELLE KOSTELECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4606 N COLLEGE DR, CHEYENNE, WY 82009-5456
(307) 414-8394
(307) 316-8125
Mailing address
815 S BRIDGE WAY PL, STE 122, EAGLE, ID 83616-6022
(208) 972-0918
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-833
WY
Other
Enumeration date
07/15/2009
Last updated
10/10/2018
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