Individual
CAROL KOSKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
800 MEDICAL CENTER DR, FAIRMONT, MN 56031-4575
(507) 238-8555
Mailing address
800 MEDICAL CENTER DR, PO BOX 800, FAIRMONT, MN 56031-4575
(507) 238-8555
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1662
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63-00305
MEDICA
MN
Enumeration date
12/12/2005
Last updated
07/09/2007
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