Individual
MRS. COLLEEN DEE KOSTIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
150 EDELLA RD, CLARKS SUMMIT, PA 18411-1628
(570) 585-2494
(570) 587-3308
Mailing address
2744 DARK REGION RD., CLARKS SUMMIT, PA 18411-9633
(570) 587-2777
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
17493
MD
225100000X
Physical Therapist
Primary
PT017714
PA
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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