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Individual

DUSTIN CLYDE TINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, LAT, CSCS

Contact information

Practice address
5765 TRAILWINDS DR, UNIT 126, FORT MYERS, FL 33907-7360
(507) 236-6728
Mailing address
5765 TRAILWINDS DR, UNIT 126, FORT MYERS, FL 33907-7360

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2363
FL

Other

Enumeration date
03/18/2008
Last updated
03/18/2008
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