Individual
MR. DUSTIN RORY GATENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3301 COLLEGE AVE, NOVA SOUTHEASTERN UNIVERSITY ATHLETIC TRAINING, DAVIE, FL 33314-7721
(754) 264-9155
Mailing address
160 ISLE OF VENICE DR, APT #22, FORT LAUDERDALE, FL 33301-1459
(954) 262-8246
(954) 262-3740
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1757
FL
Other
Enumeration date
03/06/2007
Last updated
05/19/2009
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