Individual
LAURA BETH KOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-7776
Mailing address
10144 W VIENNA AVE, WAUWATOSA, WI 53222-2353
(414) 219-7776
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
757-039
WI
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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