Individual
DYLAN FANELLI RIEDESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
225 E WARD ST, GOLIAD, TX 77963-4006
(361) 645-8902
Mailing address
41 E GROUSE RD, VICTORIA, TX 77905-0516
(361) 550-8703
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
127890
TX
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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