Provider Demographics
NPI:1790412930
Name:DUNWOODY, MICHAEL JACOB (DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JACOB
Last Name:DUNWOODY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8650 MINNIE BROWN RD STE 234
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7433
Mailing Address - Country:US
Mailing Address - Phone:334-224-1537
Mailing Address - Fax:
Practice Address - Street 1:335 MACON ST STE A
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-1898
Practice Address - Country:US
Practice Address - Phone:334-224-1537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL55698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist