Individual
MR. MICHAEL COSTA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.S.
Contact information
Practice address
1251 WHITE MOUNTAIN HWY, NORTH CONWAY, NH 03860-5154
(603) 356-7294
Mailing address
476 ROCKY KNOLL RD, DENMARK, ME 04022-5136
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1333
NH
Other
Enumeration date
07/27/2019
Last updated
07/27/2019
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