Provider Demographics
NPI:1679586085
Name:UNGER, JOHN T (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:UNGER
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 1:201 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3617
Mailing Address - Country:US
Mailing Address - Phone:970-249-5551
Mailing Address - Fax:970-249-8690
Practice Address - Street 1:201 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3617
Practice Address - Country:US
Practice Address - Phone:970-249-5551
Practice Address - Fax:970-249-8690
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC349308Medicare PIN