Healthcare Provider Details
I. General information
NPI: 1851616924
Provider Name (Legal Business Name): CUNNINGHAM CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/01/2010
Last Update Date: 04/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2204 EDGEMERE DR
PLAINVIEW TX
79072-3754
US
IV. Provider business mailing address
2204 EDGEMERE DR
PLAINVIEW TX
79072-3754
US
V. Phone/Fax
- Phone: 806-293-3130
- Fax: 806-293-3747
- Phone: 806-293-3130
- Fax: 806-293-3747
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2691 |
| License Number State | TX |
VIII. Authorized Official
Name:
THOMAS
N
CUNNINGHAM
Title or Position: OWNER
Credential: D.C.
Phone: 806-293-3130