Provider Demographics
NPI:1225434905
Name:DUNN, MARGARET (PTA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 W CLAY RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:MO
Mailing Address - Zip Code:65084-1177
Mailing Address - Country:US
Mailing Address - Phone:573-378-5312
Mailing Address - Fax:573-378-5541
Practice Address - Street 1:1101 W CLAY RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:MO
Practice Address - Zip Code:65084-1177
Practice Address - Country:US
Practice Address - Phone:573-378-5312
Practice Address - Fax:573-378-5541
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116008247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other