MEDICARE: MR. CHRIS T DUNLOP P.T.

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
1	225100000X	Physical Therapist	PT00003715	WA

General Provider Information

NPI Number	:	1487763504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRIS T DUNLOP P.T.

Provider Business Mailing Address
First Line	:	707 N PEARL ST STE K
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926-2938
Country	:	US
Telephone Number	:	509-962-2492
Fax Number	:	509-962-5836

Provider Business Practice Location Address
First Line	:	707 N PEARL ST STE K
Second Line	:
City	:	ELLENSBURG
State	:	WA
Zip	:	98926-2938
Country	:	US
Telephone Number	:	509-962-2492
Fax Number	:	509-962-5836

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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