Provider Demographics
NPI:1801958319
Name:DUNLAP, WALTER KEVIN (OTR)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:KEVIN
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9840 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-9313
Mailing Address - Country:US
Mailing Address - Phone:251-634-1843
Mailing Address - Fax:
Practice Address - Street 1:820 UNIVERSITY BLVD S
Practice Address - Street 2:2A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-7858
Practice Address - Country:US
Practice Address - Phone:251-341-0707
Practice Address - Fax:251-341-4263
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2413225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist