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Individual

MRS. ALISA KOSMITIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.C.D

Contact information

Practice address
1408 W 43RD AVE, PINE BLUFF, AR 71603-7010
(870) 535-5719
(870) 536-1963
Mailing address
1408 W 43RD AVE, PINE BLUFF, AR 71603-7010
(870) 535-5719
(870) 536-1963

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A#117
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
184762720
AR
Enumeration date
08/06/2010
Last updated
01/12/2011
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