Basic Information
| Provider Information | |||||||||
| NPI: | 1194297184 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNNAGAN | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | ERIN | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11504 KENN RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452402530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137711779 | ||||||||
| FaxNumber: | 5137711000 | ||||||||
| Practice Location | |||||||||
| Address1: | 779 GLENDALE MILFORD RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452151161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137711779 | ||||||||
| FaxNumber: | 5137711000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2019 | ||||||||
| LastUpdateDate: | 01/02/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | PTA-05570 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.