Individual
GARRETT COSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4437 MAIN ST, SHALLOTTE, NC 28470-4451
(910) 754-4449
(910) 754-3495
Mailing address
4437 MAIN ST, SHALLOTTE, NC 28470-4451
(910) 754-4449
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
128151
NC
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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