Individual
MRS. STACY LYNN DIBBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1051 GABBEY RD, CORFU, NY 14036-9788
(585) 356-4494
Mailing address
1051 GABBEY RD, CORFU, NY 14036-9788
(585) 356-4494
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
007041-1
NY
225700000X
Massage Therapist
016327-1
NY
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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