Provider Demographics
NPI:1417089939
Name:ROUNDS, DUSTIN ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:ALLEN
Last Name:ROUNDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 2ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:WAUKON
Mailing Address - State:IA
Mailing Address - Zip Code:52172-1140
Mailing Address - Country:US
Mailing Address - Phone:563-568-4462
Mailing Address - Fax:
Practice Address - Street 1:508 ROSSVILLE RD
Practice Address - Street 2:
Practice Address - City:WAUKON
Practice Address - State:IA
Practice Address - Zip Code:52172-2226
Practice Address - Country:US
Practice Address - Phone:563-568-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor