Provider Demographics
NPI:1619204047
Name:DUNBAR, KENDAL ELIZABETH (LMT)
Entity Type:Individual
Prefix:MRS
First Name:KENDAL
Middle Name:ELIZABETH
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BUNNELL ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:ATTICA
Mailing Address - State:NY
Mailing Address - Zip Code:14011-1005
Mailing Address - Country:US
Mailing Address - Phone:585-813-3798
Mailing Address - Fax:
Practice Address - Street 1:420 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-9347
Practice Address - Country:US
Practice Address - Phone:585-786-0840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023142-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist