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1134134927
JACQUELYN ANN COSTABILO
MINNEAPOLIS, MN
NPI
1134134927
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: MN 2353)
Enumeration Date
2006-07-30
Last Update Date
2007-07-08
Business Address
MRS. JACQUELYN ANN COSTABILO RD, LD
1 VETERANS DR
MINNEAPOLIS, MN 55417-2309
Phone number: 612-467-4295
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Mailing Address
MRS. JACQUELYN ANN COSTABILO RD, LD
10995 OAK GROVE CIR UNIT B
WOODBURY, MN 55129-8727
Phone number: 651-436-3761
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