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NPI Code Detail

MEDICARE: MRS. AMY LYNNE DUNDON OTRL

MEDICARE: MRS. AMY LYNNE DUNDON OTRL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist4803NC

General Provider Information

NPI Number : 1154542199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY LYNNE DUNDON OTRL
Provider Business Mailing Address
First Line : 4421 STUART ANDREW BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28217-1589
Country : US
Telephone Number : 980-343-6960
Fax Number :
Provider Business Practice Location Address
First Line : 4421 STUART ANDREW BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28217-1589
Country : US
Telephone Number : 980-343-6960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 06/10/2026

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