Individual
PAULA AUGUSTINA KOSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
390 E PARKCENTER BLVD, SUITE 130, BOISE, ID 83706-6662
(208) 336-8433
(208) 336-8441
Mailing address
11481 SW HALL BLVD, SUITE 201, PORTLAND, OR 97223-8403
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2853
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770878779
—
ID
Enumeration date
06/17/2011
Last updated
10/31/2011
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