Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA18753 | FL |
NPI | 1003023623 |
---|---|
Provider Name | Ms. Kathleen Ann Kosowsky |
First Address | Tequesta, FL 33469-1677 |
Second Address | Jupiter, FL 33458-7205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |