Provider Demographics
NPI:1346585130
Name:DUNLAP, CHARLES (PT)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25933 WOODPATH TRL
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5713
Mailing Address - Country:US
Mailing Address - Phone:440-777-6755
Mailing Address - Fax:
Practice Address - Street 1:25933 WOODPATH TRL
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5713
Practice Address - Country:US
Practice Address - Phone:440-777-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 006625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist