Provider Demographics
NPI:1881914869
Name:DUNBAR, ORENTHAL JAMES (MED, ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:ORENTHAL
Middle Name:JAMES
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:MED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-5324
Mailing Address - Country:US
Mailing Address - Phone:706-231-1333
Mailing Address - Fax:
Practice Address - Street 1:704 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-5324
Practice Address - Country:US
Practice Address - Phone:706-231-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1004020722255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer