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Individual

MRS. DIANE CAROL FISTLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
303 N HURSTBOURNE PKWY, SUITE 200, LOUISVILLE, KY 40222-5185
(502) 412-5847
Mailing address
460 FRANKLIN LAKE CIR, OXFORD, MI 48371-6705
(248) 969-7779

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005076
MI
225100000X
Physical Therapist
PT.012303
OH

Other

Enumeration date
08/20/2012
Last updated
08/20/2012
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