Individual
MICHAEL COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
9 DOG LN STE 108, STORRS, CT 06268-2239
(860) 429-0899
Mailing address
108 EDGEWATER DR, COVENTRY, CT 06238-2704
(203) 561-5235
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13390
CT
Other
Enumeration date
11/17/2021
Last updated
11/29/2021
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