Provider Demographics
NPI:1134471329
Name:DUNKLEY, OWEN LLYOD (PTA)
Entity Type:Individual
Prefix:MR
First Name:OWEN
Middle Name:LLYOD
Last Name:DUNKLEY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 RICH DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6534
Mailing Address - Country:US
Mailing Address - Phone:561-856-1354
Mailing Address - Fax:
Practice Address - Street 1:203 RICH DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-6534
Practice Address - Country:US
Practice Address - Phone:561-856-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 19732225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant