Individual
DUSTIN DORSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
203 HALLMARK AVE, LAFAYETTE, LA 70508-7766
(337) 356-8050
Mailing address
203 HALLMARK AVE, LAFAYETTE, LA 70508-7766
(337) 356-8050
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
47-1407033
LA
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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