Individual
MICHAEL JAMES DISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, CCSP
Contact information
Practice address
56 N HADDON AVE LOWR LEVEL, HADDONFIELD, NJ 08033-2438
(856) 240-7529
Mailing address
9 GREENVALE RD, MOORESTOWN, NJ 08057-2234
(203) 241-4574
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
N-A
NY
111NS0005X
Sports Physician Chiropractor
Primary
38MC00760100
NJ
Other
Enumeration date
02/05/2011
Last updated
11/27/2024
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