Provider Demographics
NPI:1578765731
Name:DUNBAR, SALLY ANN (PTA)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:ANN
Last Name:DUNBAR
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:PHYSIOTHERAPY ASSOCIATES
Mailing Address - Street 2:1665 HAMILTON ROAD
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864
Mailing Address - Country:US
Mailing Address - Phone:517-349-1110
Mailing Address - Fax:517-349-6892
Practice Address - Street 1:PHYSIOTHERAPY ASSOCIATES
Practice Address - Street 2:1665 HAMILTON ROAD
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864
Practice Address - Country:US
Practice Address - Phone:517-349-1110
Practice Address - Fax:517-349-6892
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30658OtherBCBS AND BCN
MI30658OtherBCBS AND BCN