Individual
STEPHAN GEORGE KOSSIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
759 45TH AVE STE 101, MUNSTER, IN 46321-2939
(219) 922-6226
Mailing address
123 N MAIN ST, STE 102, CROWN POINT, IN 46307-4077
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003955B
IN
Other
Enumeration date
05/24/2016
Last updated
04/25/2020
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