Individual
DUSTIN J PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4310 BAYSIDE DR, KISSIMMEE, FL 34746-6054
(813) 312-5135
Mailing address
4310 BAYSIDE DR, KISSIMMEE, FL 34746-6054
(813) 312-5135
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
29196
FL
Other
Enumeration date
02/13/2021
Last updated
02/13/2021
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