Individual
DUSTY SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4216 MACCORKLE AVE SE STE 4, CHARLESTON, WV 25304-2512
(304) 926-0913
(304) 926-0914
Mailing address
4216 MACCORKLE AVE SE STE 4, CHARLESTON, WV 25304-2512
(304) 926-0913
(304) 926-0914
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002382
WV
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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