Individual
AMANDA DORSTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT, M.ED.
Contact information
Practice address
6216 66TH ST, LUBBOCK, TX 79409
(937) 286-0131
Mailing address
6216 66TH ST, APT 518, LUBBOCK, TX 79424
(937) 286-0131
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6052
TX
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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