Individual
DUSTIN KATHLEEN JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2817 STARK ST, FT WORTH, TX 76112-6562
(817) 361-1517
Mailing address
3845 IRISH SETTER DR, FT WORTH, TX 76123-2596
(817) 361-1517
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
110585
TX
Other
Enumeration date
07/06/2007
Last updated
07/08/2007
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