Doctor Name: | ALAN COLESTOCK |
NPI Number: | 1730137720 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, ATC |
License Number: | 5501002252 |
Business Practice Address: | 7000 Portage Rd Kalamazoo, MI - 490010102 |
Business Phone Number: | 2698336242 |
Business Fax Number: | |
Mailing Address: | 5915 Old Msn, PORTAGE |
State: | MI |
Postal Code: | 490241155 |
Phone Number: | 2693294608 |
Fax Number: | |
NPI Enumeration Date: | 05/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 5501002252 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |