Provider Demographics
NPI:1477505675
Name:DUNTON, THERESA ANN (DC)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:ANN
Last Name:DUNTON
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 1:1 CLOVERLEAF SQUARE
Mailing Address - Street 2:BUILDING E SUITE 1
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219
Mailing Address - Country:US
Mailing Address - Phone:276-523-7128
Mailing Address - Fax:276-523-7213
Practice Address - Street 1:1 CLOVERLEAF SQUARE
Practice Address - Street 2:BUILDING E SUITE 1
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219
Practice Address - Country:US
Practice Address - Phone:276-523-7128
Practice Address - Fax:276-523-7213
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001636111N00000X
NH2211095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5001443OtherAETNA
VA9534679Medicaid
VA241125OtherANTHEM
VA241125OtherANTHEM