Provider Demographics
NPI:1295324812
Name:PUN, DEBBIE (DC)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:PUN
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 1:358 N 1100 E STE 3
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3250
Mailing Address - Country:US
Mailing Address - Phone:801-960-0541
Mailing Address - Fax:
Practice Address - Street 1:358 N 1100 E STE 3
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-3250
Practice Address - Country:US
Practice Address - Phone:801-960-0541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12092162-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor