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Individual
KELLY L COSTA
Active
Individual
KELLY L COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
037470
NY
225100000X
Physical Therapist
P91676
NY
Other
Enumeration date
01/04/2014
Last updated
12/10/2021
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