Individual
DANE MICHAEL STAPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
17233 N HOLMES BLVD STE 1650, PHOENIX, AZ 85053-2031
(602) 547-1836
Mailing address
17233 N HOLMES BLVD STE 1650, PHOENIX, AZ 85053-2031
(602) 547-1836
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
30527
AZ
225100000X
Physical Therapist
5501018808
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30527
LICENSE
AZ
Enumeration date
08/07/2018
Last updated
02/21/2019
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