Individual
BRIDGETTE RENEE KOSELKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 W HOMER ST, STE 106, MICHIGAN CITY, IN 46360-4358
(219) 861-8814
(219) 861-8813
Mailing address
10649 W 1500 S, WANATAH, IN 46390-9734
(219) 733-9695
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001482A
IN
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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