Provider Demographics
NPI:1699048520
Name:DUNSTAN, KATHERINE (LMT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:DUNSTAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1988 S 600 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3050
Mailing Address - Country:US
Mailing Address - Phone:248-302-2108
Mailing Address - Fax:
Practice Address - Street 1:1988 S 600 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3050
Practice Address - Country:US
Practice Address - Phone:248-302-2108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7317135-4701172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist