Provider Demographics
NPI:1811616469
Name:GUNDERSON, STEVEN RAY (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAY
Last Name:GUNDERSON
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 1:1924 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:IA
Mailing Address - Zip Code:50220-1215
Mailing Address - Country:US
Mailing Address - Phone:515-979-3905
Mailing Address - Fax:
Practice Address - Street 1:1924 2ND ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220-1215
Practice Address - Country:US
Practice Address - Phone:515-979-3905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA115176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty