Provider Demographics
NPI:1063708246
Name:CUNNINGHAM PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:CUNNINGHAM PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:910-880-4963
Mailing Address - Street 1:219 CROOKED GULLEY CIR
Mailing Address - Street 2:
Mailing Address - City:SUNSET BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28468-4452
Mailing Address - Country:US
Mailing Address - Phone:910-880-4963
Mailing Address - Fax:910-579-9728
Practice Address - Street 1:219 CROOKED GULLEY CIR
Practice Address - Street 2:
Practice Address - City:SUNSET BEACH
Practice Address - State:NC
Practice Address - Zip Code:28468-4452
Practice Address - Country:US
Practice Address - Phone:910-880-4963
Practice Address - Fax:910-579-9728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty