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Individual

MRS. LYNN MARIE DISTASIO

Active
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Individual

MRS. LYNN MARIE DISTASIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006913L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0661771
BLUE SHIELD
01
076541
FIRST PRIORITY
01
397908
HEALTH AMERICA ASSURANCE
01
442518
HEALTH AMERICA ASSURANCE
01
442539
HEALTH AMERICA ASSURANCE
01
813831
FIRST PRIORITY
01
815826
FIRST PRIORITY
Enumeration date
11/28/2006
Last updated
07/08/2007
About Stedi
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