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Individual

EILEEN KOSZTOWNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2961 WALMSLEY CIRCLE DR, LAKE ORION, MI 48360-1647
(248) 941-4217
Mailing address
4104 BOLD MDWS, OAKLAND TWP, MI 48306-1489

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704279336
MI

Other

Enumeration date
09/01/2015
Last updated
10/25/2021
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