Provider Demographics
NPI:1881881449
Name:MICHELLE L DUNAJCIK, LLC
Entity type:Organization
Organization Name:MICHELLE L DUNAJCIK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DUNAJCIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-947-4042
Mailing Address - Street 1:3 OAK TREE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-3706
Mailing Address - Country:US
Mailing Address - Phone:636-577-2762
Mailing Address - Fax:
Practice Address - Street 1:1398 S 5TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2444
Practice Address - Country:US
Practice Address - Phone:636-947-4042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003027879111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty