Larry Patrick Costello

NPI #1740857184 in Clear Lake, Iowa

Provider Information

NPI Number: 1740857184
Entity Type: Individual
Name: Larry Patrick Costello
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Jun 4, 2021
Last Updated: Jun 4, 2021

Practice Location

Address: 4668 N SHORE DR
City: Clear Lake
State: Iowa
ZIP Code: 50428-1275
Phone: (641) 529-0820

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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