Provider Demographics
NPI:1639103880
Name:DUNN CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:DUNN CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-927-2961
Mailing Address - Street 1:115 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-1535
Mailing Address - Country:US
Mailing Address - Phone:563-927-2961
Mailing Address - Fax:563-927-3846
Practice Address - Street 1:115 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1535
Practice Address - Country:US
Practice Address - Phone:563-927-2961
Practice Address - Fax:563-927-3846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07132OtherWELLMARK - BLUE CROSS & B
IA0107938Medicaid
IA07132Medicare ID - Type UnspecifiedCHIROPRACTOR