Individual
MISS DANELLE DYKSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7050 S 24TH ST, PHOENIX, AZ 85042-5806
(602) 243-8232
Mailing address
701 W GROVE PKWY APT 360, TEMPE, AZ 85283-4509
(480) 735-9346
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0663
AZ
Other
Enumeration date
02/13/2007
Last updated
04/09/2009
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