Individual
RYAN PHILIP COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 E COLLEGE ST, BRIDGEWATER, VA 22812-1511
(703) 398-6836
Mailing address
113 CINDIE LN, BRIDGEWATER, VA 22812-9218
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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