MEDICARE: DR. CAROL MARIE CUNNINGHAM DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NI0013X	Independent Medical Examiner Chiropractor	5995	FL

General Provider Information

NPI Number	:	1114254489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL MARIE CUNNINGHAM DC

Provider Business Mailing Address
First Line	:	1319 E 7TH AVE
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-5807
Country	:	US
Telephone Number	:	850-878-5845
Fax Number	:	850-878-5257

Provider Business Practice Location Address
First Line	:	1319 E 7TH AVE
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-5807
Country	:	US
Telephone Number	:	850-878-5845
Fax Number	:	850-878-5257

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2009
Last Update Date	:	11/07/2009

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