Individual
JENNIFER KAY DUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
6500 BYRON CENTER AVE SW STE 202, BYRON CENTER, MI 49315-9083
(616) 249-0750
(616) 249-0794
Mailing address
5060 CASCADE RD SE STE A, GRAND RAPIDS, MI 49546-3808
(616) 249-0750
(616) 249-0794
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070.021225
IL
225100000X
Physical Therapist
Primary
5501012054
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501012054
P.T. LICENSE
MI
Enumeration date
08/25/2006
Last updated
09/21/2021
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