Individual
COURTNEY JEAN COSTILOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.EEGT.
Contact information
Practice address
3410 W TACON ST, TAMPA, FL 33629-7927
(813) 802-8502
Mailing address
3410 W TACON ST, TAMPA, FL 33629-7927
(813) 802-8502
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
4897
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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