Provider Demographics
NPI:1841334703
Name:CUNNINGHAM, GERALD (DC)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15901 HIGHWAY 72
Mailing Address - Street 2:PO BOX 362
Mailing Address - City:ROGERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35652-7917
Mailing Address - Country:US
Mailing Address - Phone:256-247-0233
Mailing Address - Fax:
Practice Address - Street 1:15901 HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35652-7917
Practice Address - Country:US
Practice Address - Phone:256-247-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1544111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor