Individual
ETHEL C COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5500 BROOKTREE RD, SUITE 102, WEXFORD, PA 15090-9260
(180) 067-7120
Mailing address
191 GINKGO CT, CHAMBERSBURG, PA 17201-3921
(717) 261-4174
(717) 261-1092
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012024L
PA
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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