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General NPI Number Information
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NPI Number | 1154786580
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Entity Type | Individual
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Provider Name | DANE CUNNINGHAM D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 24870 S TAMIAMI TRL SUITE 3
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-7012
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Country | US
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Telephone | 800-596-3083
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 110052
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City | NAPLES
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State | FL
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Zip | 34108-0101
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Country | US
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Telephone | 978-340-1045
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH11388
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License Number State | FL
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