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1992814545
JESSICA SUE COSTAKES
ST AUGUSTINE, FL
NPI
1992814545
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Former Name
JESSICA SUE KECK
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
Enumeration Date
2006-08-29
Last Update Date
2008-10-07
Business Address
-- JESSICA SUE COSTAKES PT
190 SOUTHPARK BLVD SUITE 100
ST AUGUSTINE, FL 32086-4120
Phone number: 904-824-1478
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Mailing Address
-- JESSICA SUE COSTAKES PT
3572 MARLINSPIKE DR
TAMPA, FL 33607-5871
Phone number: 517-214-2713
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