Provider Demographics
NPI:1588135255
Name:WEBB, DUSTIN RAY
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:RAY
Last Name:WEBB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MAPLE ROW BLVD STE 560
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4788
Mailing Address - Country:US
Mailing Address - Phone:615-234-5510
Mailing Address - Fax:
Practice Address - Street 1:132 MAPLE ROW BLVD STE 560
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4788
Practice Address - Country:US
Practice Address - Phone:615-234-5510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor