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Individual
STEPHANIE ANN DISTEL
Active
Individual
STEPHANIE ANN DISTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 20736
FL
Other
Enumeration date
02/10/2009
Last updated
02/10/2009
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