Individual
DYLAN BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
4809 BROADMOOR ST APT 44, MISSION, KS 66202-1443
(316) 207-0366
Mailing address
4809 BROADMOOR ST APT 44, MISSION, KS 66202-1443
(316) 207-0366
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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