Provider Demographics
NPI:1760595920
Name:DUNN, LORI ANNE (DC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
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 1:1360 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5202
Mailing Address - Country:US
Mailing Address - Phone:203-348-8383
Mailing Address - Fax:203-961-1567
Practice Address - Street 1:1360 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5202
Practice Address - Country:US
Practice Address - Phone:203-348-8383
Practice Address - Fax:203-961-1567
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050000265CT02OtherBLUE CROSS BLUE SHIELD
CT777764OtherCONNECTICARE