Provider Demographics
NPI:1205171907
Name:DUNLAP, GREGORY A (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:DUNLAP
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 1:1364 E STROOP RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4926
Mailing Address - Country:US
Mailing Address - Phone:937-293-5300
Mailing Address - Fax:937-293-7055
Practice Address - Street 1:1364 E STROOP RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-4926
Practice Address - Country:US
Practice Address - Phone:937-293-5300
Practice Address - Fax:937-293-7055
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH226850OtherMEDICARE PTAN