Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 0104556571 | VA |
NPI | 1003000621 |
---|---|
Provider Name | Dr. Dennis Dullano |
First Address | Richmond, VA 23220-1338 |
Second Address | Farmville, VA 23901-1112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 16/02/2011 |