Provider Demographics
NPI:1598368359
Name:DUNAVANT, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:DUNAVANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6437 S BYRON RD
Mailing Address - Street 2:
Mailing Address - City:DURAND
Mailing Address - State:MI
Mailing Address - Zip Code:48429-9460
Mailing Address - Country:US
Mailing Address - Phone:989-277-2845
Mailing Address - Fax:
Practice Address - Street 1:5668 OKEMOS RD
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-9539
Practice Address - Country:US
Practice Address - Phone:517-580-5676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist