Individual
MRS. BETH ANN DUNNIVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
113 CASSELL DR, KINGSPORT, TN 37660-3775
(423) 246-7240
Mailing address
279 EDWARDS LN, BLOUNTVILLE, TN 37617-3812
(423) 360-8249
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000002982
TN
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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