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1740857184
LARRY PATRICK COSTELLO
CLEAR LAKE, IA
NPI
1740857184
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: IA 13166)
Enumeration Date
2021-06-04
Last Update Date
2021-06-04
Business Address
LARRY PATRICK COSTELLO
4668 N SHORE DR
CLEAR LAKE, IA 50428-1275
Phone number: 641-529-0820
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Mailing Address
LARRY PATRICK COSTELLO
1907 US HIGHWAY 18 E
CLEAR LAKE, IA 50428-2004
Phone number: 641-357-5271
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