Individual
DR. CARMEN LEIGH COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
310 SW WARD RD, LEES SUMMIT, MO 64081-2445
(816) 554-2211
(816) 554-2086
Mailing address
9407 EASTERN AVE, KANSAS CITY, MO 64138-4214
(816) 718-6022
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2005031064
MO
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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