Individual
PHILIP CHARLES DENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
6001 DODGE ST # FH024, OMAHA, NE 68182-1102
(218) 310-4281
Mailing address
5092 MORRIS THOMAS RD, HERMANTOWN, MN 55811-3747
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
637
NE
Other
Enumeration date
10/22/2010
Last updated
08/23/2013
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