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Individual

RICHARD SCOTT COSTAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICAL THERAPIST

Contact information

Practice address
631 ELM ST SW, STE 205, ALBANY, OR 97321-1952
(541) 967-1224
(541) 967-2750
Mailing address
11481 SW HALL BLVD, STE 201, PORTLAND, OR 97223-8403
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1048
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
280560
OR
Enumeration date
11/15/2005
Last updated
02/25/2010
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