Individual
DUSTY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, CSCS, BMS
Contact information
Practice address
6151 COUNTY ROAD 124, MCKINNEY, TX 75071-4837
(972) 645-1833
(972) 645-1834
Mailing address
6151 COUNTY ROAD 124, MCKINNEY, TX 75071-4837
(972) 645-1833
(972) 645-1834
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2062098
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2062098
PROFESSIONAL LICENSE
TX
Enumeration date
10/15/2019
Last updated
12/18/2020
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