Provider Demographics
NPI:1891998696
Name:DINI, TERRENCE J (DC)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:J
Last Name:DINI
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 1:253 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-3005
Mailing Address - Country:US
Mailing Address - Phone:307-742-9378
Mailing Address - Fax:307-742-9379
Practice Address - Street 1:253 N 3RD ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-3005
Practice Address - Country:US
Practice Address - Phone:307-742-9378
Practice Address - Fax:307-742-9379
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY306984OtherBCBS PIN#
WY35004-0178OtherRAILROAD MEDICARE#
WY83-0319184OtherTAX ID #
WY1891998696Medicare PIN