Amanda S. Costlow

NPI #1477906873 in East Grand Rapids, Michigan

Provider Information

NPI Number: 1477906873
Entity Type: Individual
Name: Amanda S. Costlow
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Jul 20, 2016
Last Updated: Jul 20, 2016

Practice Location

Address: 437 ROSEWOOD AVE SE # 2
City: East Grand Rapids
State: Michigan
ZIP Code: 49506-2825
Phone: (740) 739-1797

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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