Provider Demographics
NPI:1093752339
Name:LOMBARD, DUNFREY S (PT)
Entity Type:Individual
Prefix:MS
First Name:DUNFREY
Middle Name:S
Last Name:LOMBARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 7 LKS N
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9624
Mailing Address - Country:US
Mailing Address - Phone:910-692-8269
Mailing Address - Fax:
Practice Address - Street 1:210 S BENNETT ST
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5402
Practice Address - Country:US
Practice Address - Phone:910-692-8269
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCFH4000475OtherFIRST CAROLINA CARE
NC079PNOtherBCBS NC
NCE0397OtherMED COST
NCE0397OtherMED COST