Provider Demographics
NPI:1871884940
Name:DUNHAM CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:DUNHAM CHIROPRACTIC P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:JEREMY
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-225-7191
Mailing Address - Street 1:2120 GRAND RIVER ANX STE 100
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7390
Mailing Address - Country:US
Mailing Address - Phone:810-225-7191
Mailing Address - Fax:810-225-7192
Practice Address - Street 1:2120 GRAND RIVER ANX STE 100
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7390
Practice Address - Country:US
Practice Address - Phone:810-225-7191
Practice Address - Fax:810-225-7192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIND009811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty