Provider Demographics
NPI:1144255910
Name:CUNNINGHAM, TRACY L (DC)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:L
Last Name:CUNNINGHAM
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 1:25078 PEACHLAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2558
Mailing Address - Country:US
Mailing Address - Phone:661-255-5087
Mailing Address - Fax:661-255-5207
Practice Address - Street 1:25078 PEACHLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2558
Practice Address - Country:US
Practice Address - Phone:661-255-5087
Practice Address - Fax:661-255-5207
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20151111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology