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Individual

MR. BRIAN WILLIAM COSGROVE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.A.

Contact information

Practice address
2731 NUGGET AVE, LAKE ISABELLA, CA 93240
(760) 379-3412
(760) 379-5332
Mailing address
16225 SIERRA WAY, KERNVILLE, CA 93238-9709
(760) 793-3824

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
12/02/2010
Last updated
12/02/2010
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