=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588193304
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABIGAIL L M DUNNING DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2017
-----------------------------------------------------
Last Update Date | 04/01/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 27TH ST W STE B
-----------------------------------------------------
City | BILLINGS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59102-8602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-651-9099
-----------------------------------------------------
Fax | 406-651-4332
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5718
-----------------------------------------------------
City | KALISPELL
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59903-5718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-756-0134
-----------------------------------------------------
Fax | 406-309-2579
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251P0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Physical Therapist
-----------------------------------------------------
License Number | 12960
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 12960
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------