Individual
MR. EDWARD LEE KOSTLEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1008 E DIVISION ST, NEILLSVILLE, WI 54456-2121
(715) 743-6632
(715) 743-6679
Mailing address
1008 E DIVISION ST, NEILLSVILLE, WI 54456-2121
(715) 743-6632
(715) 743-6679
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8497-00
WI
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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