Individual
MS. MARY DARLENE KOSTELECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 13TH AVE W STE 1, DICKINSON, ND 58601-4875
(701) 227-7500
(701) 227-7575
Mailing address
300 13TH AVE W STE 1, DICKINSON, ND 58601-4875
(701) 227-7516
(701) 227-7575
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54523
—
ND
Enumeration date
12/04/2008
Last updated
08/26/2019
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