Individual
JEANNE MARIE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 CENTRE ST STE 1, MIDDLEBORO, MA 02346-2271
(508) 946-1221
Mailing address
260 CENTRE ST STE 1, MIDDLEBORO, MA 02346-2271
(508) 946-1221
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1111875
MA
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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