Provider Demographics
NPI:1093797805
Name:DUNN, ANDREA L (PT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:L
Last Name:DUNN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5320 E SHEA BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4793
Mailing Address - Country:US
Mailing Address - Phone:480-596-6999
Mailing Address - Fax:480-596-9555
Practice Address - Street 1:19636 N 27TH AVE STE LL2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4022
Practice Address - Country:US
Practice Address - Phone:623-434-7775
Practice Address - Fax:480-596-9555
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ6934225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ64913Medicare UPIN
AZZ132292Medicare PIN
AZ108469Medicare PIN