Individual
GREGG V. KOSLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3377 RIVERBEND DR, SPRINGFIELD, OR 97477-8803
(541) 222-2700
(541) 222-6113
Mailing address
3355 RIVERBEND DR STE 300, SPRINGFIELD, OR 97477-8800
(541) 868-9303
(541) 868-9306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA159940
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500651956
—
OR
Enumeration date
09/04/2012
Last updated
04/28/2023
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