Individual
DUSTIN BLAKE HENDRICK
Active
Individual
DUSTIN BLAKE HENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT028190
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT028190
PHYSICAL THERAPIST STATE LICENSE
PA
Enumeration date
04/16/2020
Last updated
04/16/2020
Update your record
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