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NPI Code Detail

MEDICARE: MELISSA ERIN DUNNAGAN PTA

MEDICARE: MELISSA ERIN DUNNAGAN PTA
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
1225200000XPhysical Therapy AssistantPTA-05570OH

General Provider Information

NPI Number : 1194297184
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ERIN DUNNAGAN PTA
Provider Business Mailing Address
First Line : 11504 KENN RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45240-2530
Country : US
Telephone Number : 513-771-1779
Fax Number : 513-771-1000
Provider Business Practice Location Address
First Line : 779 GLENDALE MILFORD RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45215-1161
Country : US
Telephone Number : 513-771-1779
Fax Number : 513-771-1000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2019
Last Update Date : 01/02/2019

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