Provider Demographics
NPI:1013566058
Name:GUNTER, DANA C
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:C
Last Name:GUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 MCCLURE BRIDGE RD STE C304
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8706
Mailing Address - Country:US
Mailing Address - Phone:678-878-3069
Mailing Address - Fax:676-878-4455
Practice Address - Street 1:3400 MCCLURE BRIDGE RD STE C304
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8706
Practice Address - Country:US
Practice Address - Phone:678-878-3069
Practice Address - Fax:676-878-4455
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT010494225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist