Individual
MR. ROBERT DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1717 W 33RD ST, EDMOND, OK 73013-3819
(405) 330-3500
Mailing address
1717 W 33RD ST, EDMOND, OK 73013-3819
(405) 330-3500
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1535
OK
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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