Individual
DUSTIN DIMALANTA KOLINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
42256 FORSYTHIA DR, FREMONT, CA 94539-4713
(510) 505-4475
Mailing address
42256 FORSYTHIA DR, FREMONT, CA 94539-4713
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000029603
CA
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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