National Provider Identifier

Shantell Dustin, DPT, PTA, ATC

Shantell Dustin, DPT, PTA, ATC is listed in the NPPES registry with a primary specialty of Physical Therapist in Depew, NY and a listed phone number of (716) 651-0100.

NPI 1629498738Depew, NYPhysical Therapist

Profile Overview

NPI
1629498738
Provider Type
Individual
Primary Specialty
Physical Therapist
Enumeration Date
April 16, 2014
Last Updated
July 19, 2021

Practice Location

  • 5190 Transit RD
  • Depew, NY 14043-4324

Phone: (716) 651-0100

Mailing Address

  • Box 8000 Dept 314
  • Buffalo, NY 14267-0002

Specialties

  • Physical Therapist (225100000X)
  • Athletic Trainer (2255A2300X)
  • Physical Therapy Assistant (225200000X)
Full Record
NPI
1629498738
Entity Type
Individual
Last Name
Dustin
First Name
Shantell
Name Prefix
Miss
Credential
DPT, PTA, ATC
Mailing Street Address
Box 8000 Dept 314
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14267-0002
Mailing Country
US
Practice Street Address
5190 Transit RD
Practice City
Depew
Practice State
NY
Practice ZIP Code
14043-4324
Practice Country
US
Practice Phone
(716) 651-0100
Enumeration Date
April 16, 2014
Last Updated
July 19, 2021
Sex
Female
Sole Proprietor
No
Certification Date
July 19, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapist (225100000X), Athletic Trainer (2255A2300X), Physical Therapy Assistant (225200000X)