Provider Demographics
NPI:1609927839
Name:DUNNAGAN, LARRY D (DC)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:D
Last Name:DUNNAGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:L
Other - Middle Name:DARIN
Other - Last Name:DUNNAGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:145 S CASCADE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3922
Mailing Address - Country:US
Mailing Address - Phone:970-252-3360
Mailing Address - Fax:970-240-6002
Practice Address - Street 1:145 S CASCADE AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3922
Practice Address - Country:US
Practice Address - Phone:970-252-3360
Practice Address - Fax:970-240-6002
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC802677Medicare PIN