Individual
DR. MICHAEL COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
475 W FINNIE FLAT RD, CAMP VERDE, AZ 86322-7398
(928) 239-3187
Mailing address
3425 W LUCIA DR, PHOENIX, AZ 85083-5886
(623) 516-7707
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S021762
AZ
Other
Enumeration date
02/21/2016
Last updated
02/21/2016
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