Individual
CHRISTINE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
499 NW PRIMA VISTA BLVD, PORT ST LUCIE, FL 34983-8786
(772) 344-1409
Mailing address
499 NW PRIMA VISTA BLVD, PORT ST LUCIE, FL 34983-8786
(772) 344-1409
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA63090
FL
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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