Individual
JOHN EUGENE BISTLINE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
501 DARBY RD, HAVERTOWN, PA 19083-4702
(610) 675-9583
Mailing address
501 DARBY RD, HAVERTOWN, PA 19083-4702
(610) 675-9583
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT006436
PA
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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