Individual
JAMES H KOSTREWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7540 N 19TH AVE STE 101, PHOENIX, AZ 85021
(602) 249-9129
(602) 249-4115
Mailing address
7540 N 19TH AVE STE 101, PHOENIX, AZ 85021-7967
(602) 249-9129
(602) 249-4115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4204
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11394042
CAQH
AZ
05
—
717150
—
AZ
Enumeration date
05/23/2005
Last updated
07/13/2018
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