Provider Demographics
NPI:1629340591
Name:DUNFEE, MICHAEL SCOT II (PTA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SCOT
Last Name:DUNFEE
Suffix:II
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6757 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:KINSMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44428-9566
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6757 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:KINSMAN
Practice Address - State:OH
Practice Address - Zip Code:44428-9566
Practice Address - Country:US
Practice Address - Phone:216-584-2720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA.07068225200000X
OHPT017835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant