Provider Demographics
NPI:1568989242
Name:DRISKILL, DUSTIN LYNN (ATC,LAT)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:LYNN
Last Name:DRISKILL
Suffix:
Gender:M
Credentials:ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 19TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-2031
Mailing Address - Country:US
Mailing Address - Phone:806-720-7284
Mailing Address - Fax:806-720-7290
Practice Address - Street 1:5601 19TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2031
Practice Address - Country:US
Practice Address - Phone:806-720-7284
Practice Address - Fax:806-720-7290
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT20992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer