MISS Shannon Brook Costella, MSPT, CERT MDT
NPI #1215987201 in Valparaiso, Indiana
Provider Information
- NPI Number
- 1215987201
- Entity Type
- Individual
- Name
- MISS Shannon Brook Costella, MSPT, CERT MDT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapist
- Credential
- MSPT, CERT MDT
- Enumeration Date
- May 11, 2006
- Last Updated
- Apr 20, 2017
Practice Location
- Address
- 2307 LAPORTE AVE
- Address 2
- SUITE 5
- City
- Valparaiso
- State
- Indiana
- ZIP Code
- 46383-6996
- Phone
- (219) 477-4500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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