Provider Demographics
NPI:1043984628
Name:DUNCAN, ADAM LEE
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:LEE
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-2425
Mailing Address - Country:US
Mailing Address - Phone:719-354-8945
Mailing Address - Fax:
Practice Address - Street 1:401 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-2127
Practice Address - Country:US
Practice Address - Phone:719-425-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician