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1366654873
JARED COSTABLE
PORTLAND, ME
NPI
1366654873
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: ME PT2905)
Enumeration Date
2007-05-04
Last Update Date
2007-07-08
Business Address
JARED COSTABLE
372 PALMER AVENUE
PORTLAND, ME 04103
Phone number: 207-409-0718
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Mailing Address
JARED COSTABLE
372 PALMER AVENUE
PORTLAND, ME 04103
Phone number: 207-409-0718
Copy
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