Provider Demographics
NPI:1609463686
Name:SUNDERMAN, DANAE (DC)
Entity type:Individual
Prefix:DR
First Name:DANAE
Middle Name:
Last Name:SUNDERMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-6195
Mailing Address - Country:US
Mailing Address - Phone:402-719-7590
Mailing Address - Fax:
Practice Address - Street 1:20324 VETERANS DR STE 103
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3552
Practice Address - Country:US
Practice Address - Phone:402-719-7590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor