Provider Demographics
NPI:1659771830
Name:DUNN, DUVELSA (DC)
Entity Type:Individual
Prefix:
First Name:DUVELSA
Middle Name:
Last Name:DUNN
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 1:986 MADISON AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9452
Mailing Address - Country:US
Mailing Address - Phone:214-329-8322
Mailing Address - Fax:
Practice Address - Street 1:986 MADISON AVE STE 1A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9452
Practice Address - Country:US
Practice Address - Phone:214-329-8322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12518111N00000X
MS1296111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor