Provider Demographics
NPI:1760426910
Name:DUNN, RONALD JOSEPH (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JOSEPH
Last Name:DUNN
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 S CEDAR LAKE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-7277
Mailing Address - Country:US
Mailing Address - Phone:573-422-1238
Mailing Address - Fax:
Practice Address - Street 1:1305 SWIFTS HWY
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-2557
Practice Address - Country:US
Practice Address - Phone:573-635-6139
Practice Address - Fax:573-635-5615
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000182255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer