Healthcare Provider Details

I. General information

NPI: 1023642485
Provider Name (Legal Business Name): DUNN PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9506 NORTON COMMONS BLVD
PROSPECT KY
40059-7520
US

IV. Provider business mailing address

PO BOX 22184
LOUISVILLE KY
40252-0184
US

V. Phone/Fax

Practice location:
  • Phone: 502-425-1716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KITTY O SAMUELS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 502-425-1716