Provider Demographics
NPI:1447781851
Name:REED, DUSTIN F (PT)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:F
Last Name:REED
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 E MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:PORT MATILDA
Mailing Address - State:PA
Mailing Address - Zip Code:16870-8406
Mailing Address - Country:US
Mailing Address - Phone:814-238-3485
Mailing Address - Fax:814-692-2272
Practice Address - Street 1:1544 E MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:PORT MATILDA
Practice Address - State:PA
Practice Address - Zip Code:16870-8406
Practice Address - Country:US
Practice Address - Phone:814-238-3485
Practice Address - Fax:814-692-2272
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist