JENNIFER L COSTILLA (NPI# 1114047495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114047495 |
Entity Type | Individual |
Full Name | JENNIFER L COSTILLA |
Credential | LMT |
Practice Address |
1823 W State St Fremont OH 43420-1635 |
Practice Telephone | 4193347737 |
Practice Fax Number | 4193342528 |
Mailing Telephone | 4193347737 |
Mailing Fax Number | 4193342528 |
Enumeration Date | 2007-03-30 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225700000X | Massage Therapist | 12817 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
1823 W STATE ST |
City | FREMONT |
State | OH |
Zip Code | 43420-1635 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780866525 | Woodville Professional Healthcare LLC | Chiropractor | 1823 W State St, Fremont, OH 43420-1635 | 2007-12-04 |
1215137567 | Rickey Wright Md LLC | General Practice | 1823 W State St, Fremont, OH 43420-1635 | 2007-07-24 |
1629090956 | Rickey Wright | General Practice | 1823 W State St, Fremont, OH 43420-1635 | 2006-07-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225596570 | Trisha D Hamm | Nurse Practitioner | Walk In Urgent Care, 2180 Sean Dr., #6b, Fremont, OH 43420 | 2019-03-06 |
1558886051 | Kortney Blair Potridge | Homemaker | 1718 Buckland Avenue, Fremont, OH 43420 | 2017-08-07 |
1699134015 | Gentle Caring Dentistry of Fremont Ohio | Dentist | 2430 Enterprise St, Fremont, OH 43420 | 2016-02-12 |
1033574587 | Alyssa Dickman | Physical Therapy Assistant | 1310 Chestnut St, Fremont, OH 43420 | 2015-12-29 |
1437566734 | Michael Allen Koebel | Registered Nurse | 1728 Oak Harbor Rd, Fremont, OH 43420 | 2014-07-18 |
1598183774 | Harry D. Burger | Dentist | 567 Bartson Rd., Fremont, OH 43420 | 2014-04-03 |
1750706636 | Lori Fisher | Registered Nurse | 500 W. State St., Suite A, Fremont, OH 43420 | 2014-02-28 |
1699113001 | Cora Renea Minich | Massage Therapist | 510 Court Street, Fremont, OH 43420 | 2013-06-07 |
1477850071 | Parschauer Eye Center Inc | Eyewear Supplier (Equipment, not the service) | 126 S. Front St, Fremont, OH 43420 | 2011-02-16 |
1316260839 | Marla D Carlisle | Physician Assistant | 605 Third Avenue, Suite B, Fremont, OH 43420 | 2010-03-11 |
Find all providers in zip 43420 |
Taxonomy Code | 225700000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | 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. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437632437 | Claire Marie J Derks | Massage Therapist | 119 North Stone Road, Fremont, MI 49412 | 2018-09-14 |
1578952172 | Donna Elane Lee | Massage Therapist | 37250 Sequoia Cmn, 1031, Fremont, CA 94536-1928 | 2015-01-20 |
1316367550 | Hai Ying Liu | Massage Therapist | 43195 Mission Blvd Ste B5, Fremont, CA 94539-5340 | 2014-04-25 |
1518390301 | Therapeutic Massage Solutions, LLC | Massage Therapist | 510 Court St, Fremont, OH 43420-2408 | 2013-08-15 |
1699113001 | Cora Renea Minich | Massage Therapist | 510 Court Street, Fremont, OH 43420 | 2013-06-07 |
1962700914 | Megumi Burr-tolliver | Massage Therapist | 4117 Stevenson Blvd Apt 216, Fremont, CA 94538-2710 | 2011-02-28 |
1558561787 | Nancy Yvonne Estep | Massage Therapist | 2274 W State St, Fremont, OH 43420-1439 | 2007-07-25 |
1376747139 | Kimberly Ann Hoffman | Massage Therapist | 125 N Prospect St, Fremont, OH 43420-4246 | 2007-06-13 |
1790805638 | Jamie Lynn Hrynciw | Massage Therapist | 1320 E State St Ste B, Fremont, OH 43420-4366 | 2007-03-31 |
1700483575 | Karen Lynn Fokes | Massage Therapist | 555 Mowry Ave Ste E, Fremont, CA 94536-4101 | 2020-10-05 |
Find all providers in FREMONT |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.