Healthcare Provider Details

I. General information

NPI: 1063620615
Provider Name (Legal Business Name): MELISSA ANN DUNIGAN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 INTERNATIONAL CIR
COLORADO SPRINGS CO
80910-3150
US

IV. Provider business mailing address

2515 FARRAGUT AVE
COLORADO SPRINGS CO
80907-6510
US

V. Phone/Fax

Practice location:
  • Phone: 719-632-2220
  • Fax:
Mailing address:
  • Phone: 719-385-0652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3862
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: