Individual
ANGELIQUE RENEE DORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
15410 S MOUNTAIN PKWY STE 112, PHOENIX, AZ 85044-6691
(480) 706-1161
Mailing address
PO BOX 6002, GRAND FORKS, ND 58206-6002
(701) 780-5000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1424
ND
225100000X
Physical Therapist
Primary
LPT-001877
AZ
Other
Enumeration date
04/25/2007
Last updated
02/07/2022
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