Mackenzie Marie Cunningham, DC
Individual provider Active NPI Chiropractor · Benton, WI
NPI 1386110773 · NPPES record last updated Oct 23, 2018
Key facts
- NPI
- 1386110773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5398-12 (WI)
- Practice address
- 188 E Main St
Benton, WI 53803-9711 - Phone
- (608) 759-6152
- NPI assigned
- Oct 23, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5398-12 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5398-12 | WI | Yes |
Addresses
Primary practice location
188 E Main St
Benton, WI 53803-9711
Mailing address
188 E Main St
Benton, WI 53803-9711
Phone (608) 759-6152
Other providers in Benton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.