Provider Demographics
NPI:1134582653
Name:DORSCHNER, DREW (DPT)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:DORSCHNER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27136 600TH ST
Mailing Address - Street 2:
Mailing Address - City:MANTORVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55955-7025
Mailing Address - Country:US
Mailing Address - Phone:507-271-0104
Mailing Address - Fax:
Practice Address - Street 1:4315 DIPLOMACY DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5926
Practice Address - Country:US
Practice Address - Phone:907-563-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9331225100000X
MA21787225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist