Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 5501300362 | MI |
NPI | 1003823246 |
---|---|
Provider Name | Mr. Patrick Allan Cosgrove |
First Address | Cadillac, MI 49601-8481 |
Second Address | Gaylord, MI 49735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/07/2007 |