Provider Demographics
NPI:1770460834
Name:DRISTLE, MARY ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:MARY ELIZABETH
Middle Name:
Last Name:DRISTLE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 48
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13153-0048
Mailing Address - Country:US
Mailing Address - Phone:315-921-6861
Mailing Address - Fax:
Practice Address - Street 1:724 S DEAVER ST,
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764
Practice Address - Country:US
Practice Address - Phone:479-259-2339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist