Provider Demographics
NPI:1992559926
Name:DUNIGAN, RYAN J (PTA)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:J
Last Name:DUNIGAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6729 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3279
Mailing Address - Country:US
Mailing Address - Phone:419-705-6647
Mailing Address - Fax:
Practice Address - Street 1:8885 BROWNING DR
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566-9701
Practice Address - Country:US
Practice Address - Phone:419-515-5448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA010041225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant