Provider Demographics
NPI:1558496687
Name:STEPHEN D CUMMINGS CH
Entity Type:Organization
Organization Name:STEPHEN D CUMMINGS CH
Other - Org Name:CUMMINGS CHIROPRACTIC OFFICE PC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:CH
Authorized Official - Phone:928-782-4339
Mailing Address - Street 1:PO BOX 890
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-0890
Mailing Address - Country:US
Mailing Address - Phone:928-782-4339
Mailing Address - Fax:
Practice Address - Street 1:242 W 28TH ST STE F
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7331
Practice Address - Country:US
Practice Address - Phone:928-782-4339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty