Individual
NICOLE ANNMARIE KOTASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3220 BRIDGE ST NW, #111, SAINT FRANCIS, MN 55070-8632
(612) 240-6601
Mailing address
4429 231ST CT NW, SAINT FRANCIS, MN 55070-8788
(612) 240-6601
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
301
MN
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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