Individual
GRACE ANN DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32 GRAHAM AVE, CORTLAND, NY 13045-2452
(607) 753-2011
Mailing address
107 CHAPEL AVE, EAST PATCHOGUE, NY 11772-5788
(631) 827-9695
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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