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1386252187
TANNER JOSEPH COSTINE
LYNCHBURG, VA
NPI
1386252187
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2020-07-17
Last Update Date
2020-07-17
Business Address
TANNER JOSEPH COSTINE ATC, LAT
1971 UNIVERSITY BLVD
LYNCHBURG, VA 24515-0002
Phone number: 919-622-0669
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Mailing Address
TANNER JOSEPH COSTINE ATC, LAT
1007 SWIFT CREEK DR
CLAYTON, NC 27520-9809
Phone number: 919-622-0669
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