Provider Demographics
NPI:1649462573
Name:DUNN, BRYAN JAMES (ATC/L, CSCS)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:JAMES
Last Name:DUNN
Suffix:
Gender:M
Credentials:ATC/L, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14901 E 88TH ST N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-4802
Mailing Address - Country:US
Mailing Address - Phone:918-272-5142
Mailing Address - Fax:
Practice Address - Street 1:12901 E 86TH ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-8734
Practice Address - Country:US
Practice Address - Phone:918-272-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAT532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer