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Individual

MR. DUSTIN M ROCKWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
314 S ELM AVE, LOGAN, IA 51546-1442
(712) 644-2922
Mailing address
5320 N ST, OMAHA, NE 68117-1837
(970) 497-0251

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
004852
IA

Other

Enumeration date
12/06/2011
Last updated
12/06/2011
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