Individual
DR. BENJAMIN PIERCE COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
51 LOCHINVAR RD, SAN RAFAEL, CA 94901-2446
(415) 497-4841
Mailing address
51 LOCHINVAR RD STE 120, SAN RAFAEL, CA 94901-2446
(415) 497-4841
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
42459
CA
Other
Enumeration date
11/19/2014
Last updated
10/02/2020
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