Provider Demographics
NPI:1669956975
Name:DUNAMIS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:DUNAMIS CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-933-8138
Mailing Address - Street 1:1112 S LAPEER RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3396
Mailing Address - Country:US
Mailing Address - Phone:810-245-1111
Mailing Address - Fax:810-245-8750
Practice Address - Street 1:1112 S LAPEER RD STE B
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3396
Practice Address - Country:US
Practice Address - Phone:810-245-1111
Practice Address - Fax:810-245-8750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty