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Individual

DUSTY K DENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1414 ARLINGTON ST, STE 2200, ADA, OK 74820-2694
(580) 371-8401
(580) 371-8402
Mailing address
15269 COUNTY ROAD 3610, ADA, OK 74820-1395
(580) 371-8401
(580) 371-8402

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2326
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100834300A
OK
Enumeration date
12/04/2008
Last updated
03/09/2017
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