ERICA LEIGH COSTELLO

CASPER, WY
NPI1760989859
Former NameERICA LEIGH CARPENTER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: WY  PA853)
Additional Taxonomies363A00000X Physician Assistant
(Licence: CA  55430)
Enumeration Date2018-04-06
Last Update Date2022-10-26
Business Address
Mrs. ERICA LEIGH COSTELLO PA-C
5840 E 2ND ST STE 200
CASPER, WY 82609-4363
Phone number: 307-316-6133
Mailing Address
Mrs. ERICA LEIGH COSTELLO PA-C
5840 E 2ND ST STE 200
CASPER, WY 82609-4363
Phone number: 307-315-6133