Individual
MARTHA COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
9506 119TH ST SW, LAKEWOOD, WA 98498-2700
(253) 661-3025
Mailing address
9506 119TH ST SW, LAKEWOOD, WA 98498-2700
(253) 661-3025
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR002555
GA
Other
Enumeration date
02/10/2016
Last updated
02/10/2016
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