Individual
DR. TAMMY LYNNE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1151 ROBERT GRISSOM PKWY, MYRTLE BEACH, SC 29577-5664
(843) 839-5588
(843) 839-5591
Mailing address
1151 ROBERT GRISSOM PKWY, MYRTLE BEACH, SC 29579
(843) 839-5588
(843) 839-5591
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
SC2755
SC
Other
Enumeration date
10/04/2006
Last updated
05/11/2009
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