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General NPI Number Information
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NPI Number | 1417156019
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Entity Type | Organization
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Legal Business Name | CUNNINGHAM CHIROPRACTIC PC
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 210 BRIDGE ST
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-2810
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Country | US
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Telephone | 315-445-9941
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Fax | 315-445-2073
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Provider Business Mailing Address
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Address Line | 210 OLD BRIDGE ST
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-2810
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Country | US
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Telephone | 315-445-9941
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Fax | 315-445-2073
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE T CUNNINGHAM
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Credential | D.C.
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Telephone | 315-445-9941
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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 | X004088-1
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License Number State | NY
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