Provider Demographics
NPI:1063450161
Name:BUNIN, LYNN K (DC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:K
Last Name:BUNIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 29TH ST
Mailing Address - Street 2:SUITE 2-D
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1214
Mailing Address - Country:US
Mailing Address - Phone:303-494-4433
Mailing Address - Fax:303-448-9705
Practice Address - Street 1:2760 29TH ST
Practice Address - Street 2:SUITE 2-D
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1214
Practice Address - Country:US
Practice Address - Phone:303-494-4433
Practice Address - Fax:303-448-9705
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO804645Medicare ID - Type UnspecifiedMEDICARE #
COU57661Medicare UPIN