Individual
MICHAEL DUNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-6600
Mailing address
402 GLEN TERRACE DR, GLENWOOD, MN 56334-1365
(320) 905-2662
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104833
MN
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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