Healthcare Provider Details

I. General information

NPI: 1477641470
Provider Name (Legal Business Name): LYNN DUMOND DUNBAR PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 WESTMARK BLVD STE 4
LAFAYETTE LA
70506-7376
US

IV. Provider business mailing address

103 WESTMARK BLVD STE 4
LAFAYETTE LA
70506-7376
US

V. Phone/Fax

Practice location:
  • Phone: 337-988-4444
  • Fax: 337-988-4478
Mailing address:
  • Phone: 337-988-4444
  • Fax: 337-988-4478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number00854
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: