Individual
MS. SANDRA MAE COSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
409 COUNTY ROAD 33, NORWICH, NY 13815-3442
(607) 334-2655
Mailing address
409 COUNTY ROAD 33, NORWICH, NY 13815-3442
(607) 334-2655
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7838
NY
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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