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General NPI Number Information
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NPI Number | 1861453086
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Entity Type | Individual
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Provider Name | SUSAN L CUNNINGHAM D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 1800 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102
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Country | US
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Telephone | 702-383-2000
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Fax | 702-383-3620
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Provider Business Mailing Address
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Address Line | 1800 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102
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Country | US
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Telephone | 702-383-2000
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Fax | 208-888-5062
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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 | B02003
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIA-1251
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DO2860
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License Number State | NV
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