Individual
KENNETH JOSEPH KOSSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
18667 IRVINE WAY, LAKEVILLE, MN 55044-4492
(952) 469-8507
(952) 469-8507
Mailing address
18667 IRVINE WAY, LAKEVILLE, MN 55044-4492
(952) 469-8507
(952) 469-8507
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
117176
MN
Other
Enumeration date
01/21/2012
Last updated
01/21/2012
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