Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1739 | FL |
NPI | 1538311659 |
---|---|
Provider Name | Mr. Michael Alphonzo Dunn |
First Address | Riviera Beach, FL 33410-7417 |
Second Address | Riviera Beach, FL 33410-7417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 21/10/2008 |