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Individual
DYLAN KASSENBROCK
Active
Individual
DYLAN KASSENBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
012377
AZ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
FS05315240076
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/08/2021
Last updated
06/23/2026
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