Individual
DUSTIN M CLARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
1825 MCFARLAND BLVD N, TUSCALOOSA, AL 35406-2251
(205) 752-1650
(205) 752-1657
Mailing address
1300 MCFARLAND BLVD NE, STE 150, TUSCALOOSA, AL 35406-2283
(205) 758-9041
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
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