Sarah Lynn Costello, DPT
Individual provider Active NPI Physical Therapist · Wilton, IA
NPI 1669605192 · NPPES record last updated Mar 30, 2018
Key facts
- NPI
- 1669605192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 004414 (IA)
- Practice address
- 400 Ovesen Dr
Wilton, IA 52778-9612 - Phone
- (563) 732-4317
- NPI assigned
- Sep 1, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004414 | IA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 004414 | IA | Yes |
Addresses
Primary practice location
400 Ovesen Dr
Wilton, IA 52778-9612
Mailing address
400 Ovesen Dr
P.O. Box 688
Wilton, IA 52778-9612
Phone (563) 732-4317
Other providers in Wilton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.