Individual
STEPHEN BRENT DORENKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3424 COACH LANTERN AVE, WAKE FOREST, NC 27587-4855
(919) 790-0364
Mailing address
3424 COACH LANTERN AVE, WAKE FOREST, NC 27587-4855
(919) 790-0364
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0460
NC
Other
Enumeration date
01/29/2016
Last updated
01/29/2016
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