Healthcare Provider Details

I. General information

NPI: 1144151481
Provider Name (Legal Business Name): JANESSA CUNNINGHAM DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 15TH AVE S
GREAT FALLS MT
59405-4324
US

IV. Provider business mailing address

2103 23RD ST S UNIT 311
GREAT FALLS MT
59405-5287
US

V. Phone/Fax

Practice location:
  • Phone: 406-455-2246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTP-PT-LIC-32499
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: