Individual
CODY CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 232-7862
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MRO-2181
ID
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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