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General NPI Number Information
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NPI Number | 1538463898
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Entity Type | Organization
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Legal Business Name | CUNNINGHAM CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 12/30/2010
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 8827 N GOVERNMENT WAY SUITE 3
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City | HAYDEN
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State | ID
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Zip | 83835-8231
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Country | US
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Telephone | 208-635-5658
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Fax | 208-635-5659
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Provider Business Mailing Address
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Address Line | 8827 N GOVERNMENT WAY SUITE 3
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City | HAYDEN
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State | ID
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Zip | 83835-8231
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Country | US
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Telephone | 208-635-5658
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Fax | 208-635-5659
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WENDY CUNNINGHAM
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Credential | D.C.
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Telephone | 208-635-5658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | CHIA-1428
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License Number State | ID
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