Provider Demographics
NPI:1194938134
Name:DUNNE, RAYMOND BRADLEY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:BRADLEY
Last Name:DUNNE
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 MERCEY SPRINGS RD, SUITE A
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635
Mailing Address - Country:US
Mailing Address - Phone:209-829-0444
Mailing Address - Fax:209-829-0445
Practice Address - Street 1:285 MERCEY SPRINGS RD, SUITE A
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635
Practice Address - Country:US
Practice Address - Phone:209-829-0444
Practice Address - Fax:209-829-0445
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26815225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist