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General NPI Number Information
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NPI Number | 1538270632
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Entity Type | Organization
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Legal Business Name | CUNNINGHAM CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 313 BROAD ST
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City | SUMTER
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State | SC
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Zip | 29150-4123
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Country | US
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Telephone | 803-938-8308
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Fax |
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Provider Business Mailing Address
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Address Line | 205 JACKSON ST
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City | FAIRMONT
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State | NC
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Zip | 28340-1619
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Country | US
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Telephone | 910-628-9592
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHANNING P CUNNINGHAM
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Credential |
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Telephone | 803-938-8308
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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 | 3077
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License Number State | SC
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