Individual
JOSEPH DISTEL
Active
Individual
JOSEPH DISTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-04742
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000355382
ANTHEM
OH
01
—
04764
PARAMOUNT
OH
05
—
2322249
—
OH
01
—
28862522000
BUREAU OF WORKERS COMP
OH
01
—
DI4057732
ADMINISTAR FEDERAL
OH
01
—
P00178552
RR MEDICARE
OH
Enumeration date
06/29/2006
Last updated
01/17/2017
Update your record
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