Provider Demographics
NPI:1811589468
Name:BUI, DUSTIN (DPT)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:
Last Name:BUI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7622 MCLAUGHLIN RD
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4710
Mailing Address - Country:US
Mailing Address - Phone:719-495-3133
Mailing Address - Fax:719-471-4415
Practice Address - Street 1:7622 MCLAUGHLIN RD
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4710
Practice Address - Country:US
Practice Address - Phone:719-495-3133
Practice Address - Fax:719-471-4415
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5946225100000X
COPTL.0018535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist