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1023448016
ANTONETTE ELLESMERE DISTAN
LANCASTER, CA
NPI
1023448016
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA 16439)
Enumeration Date
2013-11-12
Last Update Date
2013-11-12
Business Address
-- ANTONETTE ELLESMERE DISTAN
1601 ARNICA LN
LANCASTER, CA 93535-4442
Phone number: 818-601-9714
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Mailing Address
-- ANTONETTE ELLESMERE DISTAN
1601 ARNICA LN
LANCASTER, CA 93535-4442
Phone number: 818-601-9714
Copy
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