Individual
DANE ROBERT DORSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC LAT
Contact information
Practice address
444 W OSBORN RD STE 303, PHOENIX, AZ 85013-3820
(602) 279-8022
(602) 279-8029
Mailing address
444 W OSBORN RD STE 303, PHOENIX, AZ 85013-3820
(602) 279-8022
(602) 279-8029
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0944
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0944
ARIZONA BOARD OF ATHLETIC TRAINING
AZ
01
—
60802411
BOARD OF CERTIFICATION (ATHLETIC TRAINING(
—
Enumeration date
11/22/2017
Last updated
11/22/2017
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