Individual
DUSTIN TITCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
715 N BEAVER ST UNIT C, FLAGSTAFF, AZ 86001-3141
(928) 224-2847
(928) 249-3120
Mailing address
715 N BEAVER ST UNIT C, FLAGSTAFF, AZ 86001-3141
(928) 224-2847
(928) 249-3120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
11711PT
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46855
—
AZ
Enumeration date
05/29/2015
Last updated
02/02/2024
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