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1073716833
JASON COSTELLO
LAUREL, MD
NPI
1073716833
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MD A00514)
Enumeration Date
2007-06-08
Last Update Date
2007-07-08
Business Address
JASON COSTELLO
14409 GREENVIEW DR STE 102
LAUREL, MD 20708-4213
Phone number: 301-498-8100
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Mailing Address
JASON COSTELLO
14409 GREENVIEW DR STE 102
LAUREL, MD 20708-4213
Phone number: 301-498-8100
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