Provider Demographics
NPI:1912704099
Name:CUMMINGS, AUSTIN (LMT, CMT)
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:
Credentials:LMT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 MONTGOMERY BLVD NE BLDG D12
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1534
Mailing Address - Country:US
Mailing Address - Phone:502-544-7305
Mailing Address - Fax:
Practice Address - Street 1:7520 MONTGOMERY BLVD NE BLDG D12
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1534
Practice Address - Country:US
Practice Address - Phone:505-908-3826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMT9629225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist