Individual
CHRISTOPHER COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
78 AUTUMN LN, YARMOUTH, ME 04096-7702
(617) 686-2584
Mailing address
78 AUTUMN LN, YARMOUTH, ME 04096-7702
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3610
ME
Other
Enumeration date
05/13/2008
Last updated
02/24/2012
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