Provider Demographics
NPI:1598800542
Name:DUNN, DARYLE R (DC)
Entity Type:Individual
Prefix:DR
First Name:DARYLE
Middle Name:R
Last Name:DUNN
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 1:820 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-3370
Mailing Address - Country:US
Mailing Address - Phone:330-733-1203
Mailing Address - Fax:330-733-2340
Practice Address - Street 1:820 CANTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-3370
Practice Address - Country:US
Practice Address - Phone:330-733-1203
Practice Address - Fax:330-733-2340
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0913453Medicaid
OH0730471Medicare ID - Type Unspecified