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1326113994
KEVIN DONALD KOOISTRA
CLIFTON, NJ
NPI
1326113994
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
156FX1800X Technician/Technologist, Optician
(Licence: NJ 31TD00190700)
Enumeration Date
2006-11-21
Last Update Date
2011-10-26
Business Address
Mr. KEVIN DONALD KOOISTRA Optician
1033 CLIFTON AVE SUITE 107
CLIFTON, NJ 07013-3517
Phone number: 973-471-1225
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Mailing Address
Mr. KEVIN DONALD KOOISTRA Optician
1033 CLIFTON AVE SUITE 107
CLIFTON, NJ 07013-3517
Phone number: 973-471-1225
Copy
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