Costello, Bruce
Costello, Bruce is an sole proprietor health care provider with primary practice located at 2365 Wall St Se Suite 100, Conyers GA 30013-2197. He recently has only one registered license in Chiropractic Providers / Rehabilitation, which is considered as his primary health care specialty. Costello, Bruce can be contacted via phone (770) 922-8187.Contact Information
Primary practice address
2365 Wall St Se Suite 100
Conyers GA 30013-2197
Phone: (770) 922-8187
Fax: (770) 922-9107
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Rehabilitation | 111NR0400X | CHIR002554 | Georgia |
Profile Details
| NPI number | 1184974651 |
|---|---|
| LBN Legal business name | Costello, Bruce |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 12th, 2012 |
| Last updated | Sep 12th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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