Individual
MRS. MELISSA KAY KOSTREVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
223 W PARK ST, GILLETT, WI 54124-9414
(920) 855-2114
Mailing address
4935 BURG ROAD, LENA, WI 54139
(920) 829-5739
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
258019
WI
Other
Enumeration date
07/11/2007
Last updated
05/22/2026
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