Individual
ANDREW X DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
262 WILLOW AVE APT 2, SOMERVILLE, MA 02144-2263
(617) 863-7003
Mailing address
262 WILLOW AVE APT 2, SOMERVILLE, MA 02144-2263
(617) 863-7003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20296
MA
Other
Enumeration date
10/31/2012
Last updated
07/21/2020
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