Provider Demographics
NPI:1356484893
Name:BURNS, DENNIS THOMAS (DC)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:THOMAS
Last Name:BURNS
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 1:1126 22ND ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2816
Mailing Address - Country:US
Mailing Address - Phone:740-354-4352
Mailing Address - Fax:
Practice Address - Street 1:1420 CHILLICOTHE ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3444
Practice Address - Country:US
Practice Address - Phone:740-354-8824
Practice Address - Fax:740-354-8826
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1552111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0797884Medicaid
OH798046OtherWORKERSCOMP EMLPOYER RISK
OHBU0675222Medicare ID - Type Unspecified