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Individual
MATTHEW LOUIS COSTA
Active
Individual
MATTHEW LOUIS COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01331500
NJ
Other
Enumeration date
11/05/2012
Last updated
08/05/2016
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