MR. Michael Distefano, MA, ATC, CSCS, PES
NPI #1558803551 in Storrs, Connecticut
Provider Information
- NPI Number
- 1558803551
- Entity Type
- Individual
- Name
- MR. Michael Distefano, MA, ATC, CSCS, PES
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- MA, ATC, CSCS, PES
- Enumeration Date
- Nov 8, 2016
- Last Updated
- Nov 8, 2016
Practice Location
- Address
- 9 DOG LN
- Address 2
- SUITE 108
- City
- Storrs
- State
- Connecticut
- ZIP Code
- 06268-2239
- Phone
- (860) 429-0899
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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