Individual
MARCO DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT, ATC
Contact information
Practice address
7400 BAY RD, UNIVERSITY CENTER, MI 48710-0001
(989) 964-7233
Mailing address
48541 HENNINGS DR, MACOMB, MI 48044-5615
(586) 549-3663
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002258
MI
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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