Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 6550 | MN |
NPI | 1255801593 |
---|---|
Provider Name | Dr. Anthony Joseph Dungey |
First Address | Sauk Rapids, MN 56379-1597 |
Second Address | Sauk Rapids, MN 56379-1574 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2018 |
Last Update Date | 29/11/2018 |