Individual ProviderMary KosterPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4515 E Central Ave, Ste A, Wichita, KS 67208-3915(316) 260-6869(316) 263-0003PECOS EnrollmentBased on the most recent information from CMS, provider Mary Koster does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1720288731Provider TypeIndividualFull NameKoster, MaryCredentialPTGenderFemaleSole ProprietorNoEnumeration Date7/19/2007Last Updated9/23/2016Contact InformationPractice LocationPractice Address4515 E Central Ave, Ste A, Wichita, KS 67208-3915Phone(316) 260-6869Fax(316) 260-6872Mailing LocationMailing Address200 W Douglas Ave, Ste 1040, Wichita, KS 67202-3013Phone(316) 263-0003Fax(316) 263-1241Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense11-01050Kansas