Provider Demographics
NPI:1104373927
Name:DUNN, DAVID JR (LMT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DUNN
Suffix:JR
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6165 E ILIFF AVE
Mailing Address - Street 2:APT# E122
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5816
Mailing Address - Country:US
Mailing Address - Phone:615-948-7101
Mailing Address - Fax:
Practice Address - Street 1:6165 E ILIFF AVE
Practice Address - Street 2:APT# E122
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5816
Practice Address - Country:US
Practice Address - Phone:615-948-7101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018761225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist