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NPI Code Detail

MEDICARE: MRS. DIANA LYNN CUNNINGHAM PHYSICAL THERAPIST

MEDICARE:  MRS. DIANA LYNN CUNNINGHAM  PHYSICAL THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT-07002OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073634325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANA LYNN CUNNINGHAM PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 5533 MAHONING AVE FL 2
Second Line :
City : AUSTINTOWN
State : OH
Zip : 44515-2366
Country : US
Telephone Number : 330-799-0094
Fax Number : 330-799-8303
Provider Business Practice Location Address
First Line : 5533 MAHONING AVE FL 2
Second Line :
City : AUSTINTOWN
State : OH
Zip : 44515-2366
Country : US
Telephone Number : 330-799-0094
Fax Number : 330-799-8303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 01/18/2021

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Directions to “ MRS. DIANA LYNN CUNNINGHAM PHYSICAL THERAPIST” Practice Location

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