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Individual

MINDY COSTELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-7591
Mailing address
3915 BELGIAN DR, RIVERBANK, CA 95367-3108

Taxonomy

Speciality
Code
Description
License number
State
2278G1100X
General Care Certified Respiratory Therapist
Primary
29664
CA

Other

Enumeration date
02/20/2019
Last updated
02/20/2019
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