Individual
JEFFREY A COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
39 COTTAGE ST, MONROE, CT 06468-2929
(203) 455-7312
Mailing address
39 COTTAGE ST, MONROE, CT 06468-2929
(203) 455-7312
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
891
CT
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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