Provider Demographics
NPI:1649488917
Name:KLOSKA, EMILY LOUISE (DO)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LOUISE
Last Name:KLOSKA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LOUISE
Other - Last Name:ANDRINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5939 N HURON RD
Mailing Address - Street 2:
Mailing Address - City:OSCODA
Mailing Address - State:MI
Mailing Address - Zip Code:48750-9710
Mailing Address - Country:US
Mailing Address - Phone:989-739-1441
Mailing Address - Fax:989-739-6093
Practice Address - Street 1:5939 N HURON RD
Practice Address - Street 2:
Practice Address - City:OSCODA
Practice Address - State:MI
Practice Address - Zip Code:48750-9710
Practice Address - Country:US
Practice Address - Phone:989-739-1441
Practice Address - Fax:989-739-6093
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine