Basic Information
Provider Information
NPI: 1811236615
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNN
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 343
Address2:  
City: WORTHVILLE
State: KY
PostalCode: 410980343
CountryCode: US
TelephoneNumber: 5026405715
FaxNumber: 5027320315
Practice Location
Address1: 329 FLOYD DR
Address2: SUITE D2
City: CARROLLTON
State: KY
PostalCode: 410088261
CountryCode: US
TelephoneNumber: 5027320313
FaxNumber: 5027320315
Other Information
ProviderEnumerationDate: 02/14/2013
LastUpdateDate: 02/14/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X002416KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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