KENNETH COSTA

SALT LAKE CITY, UT
NPI1649319096
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: UT  6022536-2401)
Enumeration Date2007-02-05
Last Update Date2007-07-08
Business Address
-- KENNETH COSTA
1952 FORT UNION BLVD # 100
SALT LAKE CITY, UT 84121-6877
Phone number: 801-942-3311
Mailing Address
-- KENNETH COSTA
PO BOX 711185
SALT LAKE CITY, UT 84171-1185
Phone number: 801-942-3311
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