Provider Demographics
NPI:1346372133
Name:KEVIN DUNN MPT, LLC
Entity Type:Organization
Organization Name:KEVIN DUNN MPT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:405-650-1320
Mailing Address - Street 1:11205 N MAY AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6329
Mailing Address - Country:US
Mailing Address - Phone:405-650-1320
Mailing Address - Fax:405-749-2121
Practice Address - Street 1:11205 N MAY AVE
Practice Address - Street 2:SUITE C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6329
Practice Address - Country:US
Practice Address - Phone:405-650-1320
Practice Address - Fax:405-749-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3663225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty