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General NPI Number Information
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NPI Number | 1598746497
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Entity Type | Individual
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Provider Name | ALAN R DISTEL PT
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1725 WESTERN AVE SUITE B
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City | FINDLAY
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State | OH
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Zip | 45840-1345
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Country | US
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Telephone | 419-422-5526
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Fax |
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Provider Business Mailing Address
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Address Line | P O BOX 239
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City | FINDLAY
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State | OH
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Zip | 45839-1345
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Country | US
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Telephone | 419-422-5526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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