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1710193602
MARK ADRIAN COSTELLO
SAN DIEGO, CA
NPI
1710193602
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA PT 14046)
Enumeration Date
2007-05-15
Last Update Date
2007-11-13
Business Address
Mr. MARK ADRIAN COSTELLO PT
7510 CLAIREMONT MESA BLVD SUITE 103
SAN DIEGO, CA 92111-1539
Phone number: 858-277-2277
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Mailing Address
Mr. MARK ADRIAN COSTELLO PT
PO BOX 6306
SAN DIEGO, CA 92166-0306
Phone number: 619-222-5102
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