Healthcare Provider Details

I. General information

NPI: 1164247177
Provider Name (Legal Business Name): TIMOTHY KLINE DUNN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 751
COCHRANTON PA
16314-0751
US

IV. Provider business mailing address

PO BOX 751
COCHRANTON PA
16314-0751
US

V. Phone/Fax

Practice location:
  • Phone: 814-449-4195
  • Fax:
Mailing address:
  • Phone: 814-449-4195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License NumberPT008412L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: