Individual
DUSTIN MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5833 W I 20, ARLINGTON, TX 76017-1057
(817) 516-1115
Mailing address
5833 W I 20, ARLINGTON, TX 76017-1057
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1330947
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1330947
STATE LICENSE
TX
Enumeration date
06/25/2020
Last updated
02/27/2024
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