Individual
MATTHEW P DANNEKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.T
Contact information
Practice address
16049 TUSCOLA RD STE A, APPLE VALLEY, CA 92307
(760) 503-5455
Mailing address
16049 TUSCOLA RD STE A, APPLE VALLEY, CA 92307-0824
(760) 503-5455
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
33987
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33987
PHYSICAL THERAPY BOARD
CA
Enumeration date
09/25/2007
Last updated
07/19/2018
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