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1720617202
JAMES WADE COSTIN
MILWAUKEE, WI
NPI
1720617202
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-04-06
Last Update Date
2020-04-06
Business Address
JAMES WADE COSTIN
2901 W OKLAHOMA AVE
MILWAUKEE, WI 53215-4329
Phone number: 414-649-3323
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Mailing Address
JAMES WADE COSTIN
7153 EDGEWATER PL
INDIANAPOLIS, IN 46240-3020
Phone number:
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