Individual
IAN JOSEPH COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4001 GEIST RD, FAIRBANKS, AK 99709-3569
(907) 374-1981
(907) 331-0440
Mailing address
4001 GEIST RD, FAIRBANKS, AK 99709-3569
(907) 374-1981
(907) 331-0440
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
204821
AK
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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