Provider Demographics
NPI:1467117382
Name:BOYD, DUSTIN J (PT, DPT)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:J
Last Name:BOYD
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 FRUIT PARK RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81403-4576
Mailing Address - Country:US
Mailing Address - Phone:970-417-0954
Mailing Address - Fax:
Practice Address - Street 1:1076 FRUIT PARK RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81403-4576
Practice Address - Country:US
Practice Address - Phone:970-417-0954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-04
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-32068225100000X
CO0019391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist