Provider Demographics
NPI:1023270865
Name:DINI CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:DINI CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DINI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:307-742-9378
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY543261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW21964Medicare PIN