Individual
DORIAN VENABLE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
NAVAJO ROUTE 64, TSAILE, AZ 86556
(928) 724-3612
(928) 724-3671
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(928) 674-7166
(928) 674-7705
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT07319
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
933052
CDR
—
Enumeration date
03/20/2013
Last updated
03/09/2017
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