Basic Information
Provider Information
NPI: 1003000621
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DULLANO
FirstName: DENNIS
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1215 HERMITAGE RD
Address2: #2418
City: RICHMOND
State: VA
PostalCode: 232201338
CountryCode: US
TelephoneNumber: 9042347704
FaxNumber:  
Practice Location
Address1: 800 BUFFALO ST
Address2: SUITE B
City: FARMVILLE
State: VA
PostalCode: 239011112
CountryCode: US
TelephoneNumber: 4343155868
FaxNumber: 4347369895
Other Information
ProviderEnumerationDate: 08/28/2007
LastUpdateDate: 02/16/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X0104556571VAY Chiropractic ProvidersChiropractor 

No ID Information.


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