Individual
DANIEL JAMES FISTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
34 GRACEY ST, SPARTA, TN 38583-2046
(931) 836-2211
Mailing address
34 GRACEY ST, SPARTA, TN 38583-2046
(931) 836-2211
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5535
TN
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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