Provider Demographics
NPI:1083678668
Name:DUNLAP, LADELLE RENE (DC)
Entity Type:Individual
Prefix:MRS
First Name:LADELLE
Middle Name:RENE
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:RENE
Other - Middle Name:
Other - Last Name:DUNLAP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:7719 HWY 182 EAST
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380
Mailing Address - Country:US
Mailing Address - Phone:985-384-2757
Mailing Address - Fax:985-385-2287
Practice Address - Street 1:7719 HWY 182 EAST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380
Practice Address - Country:US
Practice Address - Phone:985-384-2757
Practice Address - Fax:985-385-2287
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA59341Medicare ID - Type Unspecified