Individual provider · Type 1 NPI

Jennifer L. Costilla, LMT

Massage Therapist · Fremont, OH

NPI number 1114047495 Active

Practice location

1823 W State St
Fremont, OH 43420-1635

Call (419) 334-7737 Map

Fax (419) 334-2528

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X12817 (OH)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1114047495

Jennifer L. Costilla, LMT's National Provider Identifier is 1114047495, issued on Mar 30, 2007. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Fremont, OH. The record was last updated on Jul 8, 2007.