KELLY L COSTELLO

MINNEAPOLIS, MN
NPI1588858039
Former NameKELLY L MCCORMICK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133VN1004X Dietitian, Registered Nutrition, Pediatric
(Licence: MN  1690)
Enumeration Date2007-08-28
Last Update Date2012-11-30
Business Address
KELLY L COSTELLO RD
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454-1450
Phone number: 612-273-0069
Mailing Address
KELLY L COSTELLO RD
6041 4TH AVE S
MINNEAPOLIS, MN 55419-2510
Phone number: 612-910-9579
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