Provider Demographics
NPI:1861042004
Name:DUNNING, JOEL E (MAC, LAC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:E
Last Name:DUNNING
Suffix:
Gender:M
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 S 78TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-5411
Mailing Address - Country:US
Mailing Address - Phone:402-981-5110
Mailing Address - Fax:
Practice Address - Street 1:1020 S 78TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-5411
Practice Address - Country:US
Practice Address - Phone:402-981-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist