Individual
DUSTIN GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
7307 UNIVERSITY AVE, LUBBOCK, TX 79423-1422
(806) 412-4200
(806) 412-4201
Mailing address
7307 UNIVERSITY AVE, LUBBOCK, TX 79423-1422
(806) 412-4200
(806) 412-4201
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
2097086
TX
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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