Provider Demographics
NPI:1902393903
Name:DUNNE, GRIFFIN
Entity Type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:
Last Name:DUNNE
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 1:245 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-7973
Mailing Address - Country:US
Mailing Address - Phone:570-772-0783
Mailing Address - Fax:
Practice Address - Street 1:245 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-7973
Practice Address - Country:US
Practice Address - Phone:570-772-0783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer