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Individual

DUSTY MATTHEW ALLRED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
21083 N JOHN WAYNE PKWY STE C104, MARICOPA, AZ 85139-2961
(520) 233-7555
Mailing address
37645 W SANTA CLARA AVE, MARICOPA, AZ 85138-5425

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA-012352
AZ

Other

Enumeration date
01/25/2024
Last updated
01/25/2024
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