Provider Demographics
NPI:1538277728
Name:CUMMING, KATHLEEN ANN (DC)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ANN
Last Name:CUMMING
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 1:3100 N ACADEMY BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5360
Mailing Address - Country:US
Mailing Address - Phone:719-650-0344
Mailing Address - Fax:
Practice Address - Street 1:3707 PARKMOOR VILLAGE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-6251
Practice Address - Country:US
Practice Address - Phone:719-650-0344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO457288Medicare ID - Type UnspecifiedMEDICARE NUMBER