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NPI Code Detail

MEDICARE: PATRICK DUNHAM PTA

MEDICARE: PATRICK DUNHAM PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant5502005544MI
2225200000XPhysical Therapy Assistant10057OR
3225200000XPhysical Therapy AssistantA5728MD
4225200000XPhysical Therapy Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1XXXOTHERMINA

General Provider Information

NPI Number : 1235839705
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK DUNHAM PTA
Provider Business Mailing Address
First Line : 519 AVENIDA CESAR E CHAVEZ
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-2133
Country : US
Telephone Number : 888-913-1910
Fax Number :
Provider Business Practice Location Address
First Line : 519 AVENIDA CESAR E CHAVEZ
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-2133
Country : US
Telephone Number : 888-913-1910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2023
Last Update Date : 08/10/2024

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