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General NPI Number Information
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NPI Number | 1376408815
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Entity Type | Individual
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Provider Name | CHARLANA DUNN PTA
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 1102 SIKES AVE
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City | SIKESTON
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State | MO
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Zip | 63801-5021
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Country | US
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Telephone | 573-471-5755
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Fax |
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Provider Business Mailing Address
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Address Line | 2299 STATE HWY E
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City | SCOTT CITY
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State | MO
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Zip | 63780-9193
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Country | US
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Telephone | 573-225-7896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 20150020022
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License Number State | MO
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