Provider Demographics
NPI:1790917474
Name:CUMMINGS, TERESA RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:RENEE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2427
Mailing Address - Country:US
Mailing Address - Phone:810-664-4185
Mailing Address - Fax:810-664-4291
Practice Address - Street 1:452 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2427
Practice Address - Country:US
Practice Address - Phone:810-664-4185
Practice Address - Fax:810-664-4291
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23010095539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor