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Organization

SPINAL DYNAMICS CHIROPRACTIC AND REHABILITATION SPECIALISTS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUSAN LYNNE CUNNINGHAM D.C. (CHIROPRACTIC PHYSICIAN/OWNER)
(208) 888-0055
Entity
Organization

Contact information

Practice address
3715 E OVERLAND RD, SUITE #105, MERIDIAN, ID 83642-8395
(208) 888-0055
(208) 888-5062
Mailing address
3715 E OVERLAND RD, SUITE #105, MERIDIAN, ID 83642-8395
(208) 888-0055
(208) 888-5062

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102054-NV
MEDICARE ID
NV
Enumeration date
10/09/2007
Last updated
01/10/2008
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