Provider Demographics
NPI:1912948191
Name:DUNLAP, RICHARD ERIC (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ERIC
Last Name:DUNLAP
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 1:1601 WALNUT ST
Mailing Address - Street 2:SUITE 514
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2944
Mailing Address - Country:US
Mailing Address - Phone:215-564-6680
Mailing Address - Fax:215-940-2218
Practice Address - Street 1:1601 WALNUT ST
Practice Address - Street 2:SUITE 514
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2944
Practice Address - Country:US
Practice Address - Phone:215-564-6680
Practice Address - Fax:215-940-2218
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006016-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADU655422Medicare ID - Type Unspecified