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General NPI Number Information
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NPI Number | 1649515172
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Entity Type | Individual
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Provider Name | BENJAMIN W CUNNINGHAM DPT
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Gender | Male
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 600 S 27TH ST
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City | BILLINGS
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State | MT
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Zip | 59101-4508
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Country | US
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Telephone | 406-322-5342
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Fax |
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Provider Business Mailing Address
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Address Line | 3502 SAINT JOHNS AVE
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City | BILLINGS
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State | MT
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Zip | 59102-4344
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Country | US
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Telephone | 541-729-1511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTP-PT-LIC-4458
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License Number State | MT
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