Provider Demographics
NPI:1912365313
Name:DUNKEL, KATHRYN GAYLE (DPT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GAYLE
Last Name:DUNKEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:GAYLE
Other - Last Name:CLAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1618 MEHTA LN
Mailing Address - Street 2:
Mailing Address - City:FORT ATKINSON
Mailing Address - State:WI
Mailing Address - Zip Code:53538-9178
Mailing Address - Country:US
Mailing Address - Phone:920-568-9739
Mailing Address - Fax:920-568-9742
Practice Address - Street 1:1618 MEHTA LN
Practice Address - Street 2:
Practice Address - City:FORT ATKINSON
Practice Address - State:WI
Practice Address - Zip Code:53538-9178
Practice Address - Country:US
Practice Address - Phone:920-568-9739
Practice Address - Fax:920-568-9742
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43506225100000X
WI13099-24225100000X
IL070021447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist