Provider Demographics
NPI:1801818000
Name:CUNNINGHAM, KEVIN ARTHUR (DC, PHD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ARTHUR
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:DC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ELDRIDGE
Mailing Address - State:IA
Mailing Address - Zip Code:52748-1259
Mailing Address - Country:US
Mailing Address - Phone:563-285-5770
Mailing Address - Fax:563-285-9818
Practice Address - Street 1:312 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748-1259
Practice Address - Country:US
Practice Address - Phone:563-285-5770
Practice Address - Fax:563-285-9818
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA03774Medicare ID - Type UnspecifiedPROVIDER NUMBER