Provider Demographics
NPI:1982395620
Name:CUNNINGHAM, TYLER DALE (PT, DPT)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:DALE
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 MCFARLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-3326
Mailing Address - Country:US
Mailing Address - Phone:205-333-5351
Mailing Address - Fax:205-333-5345
Practice Address - Street 1:212 MCFARLAND BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3326
Practice Address - Country:US
Practice Address - Phone:205-333-5351
Practice Address - Fax:205-333-5345
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPT11320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist