Doctor Name: | DR. CHARLES R CUNICO |
NPI Number: | 1760755052 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 15949 |
Business Practice Address: | 624 E Henri De Tonti Blvd Springdale, AR - 727629722 |
Business Phone Number: | 4793611112 |
Business Fax Number: | 4793611120 |
Mailing Address: | 2965 Lavita Ln, DALLAS |
State: | TX |
Postal Code: | 752346488 |
Phone Number: | 4792001644 |
Fax Number: | |
NPI Enumeration Date: | 02/16/2012 |
NPI Last Update Date: | 03/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 15949 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |