Individual
MS. CORY LYN COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, LMT, NMT
Contact information
Practice address
1601 2ND AVE N STE 516, GREAT FALLS, MT 59401-3289
(406) 868-6316
(406) 868-6316
Mailing address
2601 8TH AVE N, GREAT FALLS, MT 59401-2059
(406) 868-6316
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-10081
MT
Other
Enumeration date
08/13/2017
Last updated
08/13/2017
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