Individual
DUSTIN M CLARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH 2715
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051518450
BLUE CROSS PROVIDER #
AL
01
—
051531512
BLUE CROSS PROVIDER #
AL
01
—
412166803
TAX ID
AL
01
—
522381365
TAX ID
AL
Enumeration date
10/12/2006
Last updated
07/18/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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