| NPI | 1053778415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH COSTELLO Podiatrist 660-342-0175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2014003755) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2022-06-03 |