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Individual

DR. PETER ANTHONY COSTANTINO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
29856 SCHOENHERR RD, SUITE 2, WARREN, MI 48088-3600
(586) 443-5000
(586) 443-5002
Mailing address
29856 SCHOENHERR RD, SUITE 2, WARREN, MI 48088-3600
(586) 443-5000
(586) 443-5002

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301005635
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
950E053280
BCBSM
MI
Enumeration date
03/02/2007
Last updated
07/08/2007
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