Individual
MR. JOSHUA CHRISTIAN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
20 CHARTER OAK DR, GROTON, CT 06340-2905
(231) 670-0930
Mailing address
20 CHARTER OAK DR, GROTON, CT 06340-2905
(231) 670-0930
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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