Individual
DUSTIN VANVOLKENBURGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
104 RENAISSANCE CIR, MAULDIN, SC 29662-2455
(864) 670-4436
Mailing address
445 SEABREEZE DR, INDIALANTIC, FL 32903-4130
(321) 412-5780
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4310
SC
Other
Enumeration date
12/05/2014
Last updated
11/11/2015
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