Individual
MR. GREGORY M KOSTAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
70 HERRING POND RD, PLYMOUTH, MA 02360-1913
(781) 983-7681
Mailing address
70 HERRING POND RD, PLYMOUTH, MA 02360-1913
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN86528
MA
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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