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1710910013
KYLE JEFFREY KOSTYUN
FARMINGTON, CT
NPI
1710910013
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL 010602021)
Enumeration Date
2006-07-09
Last Update Date
2017-07-18
Business Address
Mr. KYLE JEFFREY KOSTYUN ATC
399 FARMINGTON AVE 3RD FLOOR
FARMINGTON, CT 06032-1936
Phone number: 860-284-0235
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Mailing Address
Mr. KYLE JEFFREY KOSTYUN ATC
221 HOLLISTER DR
AVON, CT 06001-2934
Phone number: 813-416-5546
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