Individual
THOMAS DUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1001 HEALTH CENTER DR, MATTOON, IL 61938-4693
(217) 258-2250
(217) 258-2249
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-005945
IL
Other
Enumeration date
12/12/2013
Last updated
02/28/2025
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