Provider Demographics
NPI:1609909407
Name:OSTER-KOSTUCH, CATHERINE JANE (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:JANE
Last Name:OSTER-KOSTUCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27101 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1917
Mailing Address - Country:US
Mailing Address - Phone:586-772-3040
Mailing Address - Fax:586-772-3074
Practice Address - Street 1:27101 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1917
Practice Address - Country:US
Practice Address - Phone:586-772-3040
Practice Address - Fax:586-772-3074
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI006029111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic