Individual
THOMAS MICHAEL COSTELLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.EP.T., CNIM
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 629-4800
Mailing address
2838 PLANTATION CT, SELLERSBURG, IN 47172-9172
(812) 246-5228
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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