MEDICARE: VALERIE D CUNNINGHAM MS PT

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
1	225100000X	Physical Therapist	2305204383	VA

General Provider Information

NPI Number	:	1508980228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE D CUNNINGHAM MS PT

Provider Business Mailing Address
First Line	:	2346 MOUNTAIN HILL RD
Second Line	:
City	:	PALMYRA
State	:	VA
Zip	:	22963-5307
Country	:	US
Telephone Number	:	434-842-1404
Fax Number	:

Provider Business Practice Location Address
First Line	:	2346 MOUNTAIN HILL RD
Second Line	:
City	:	PALMYRA
State	:	VA
Zip	:	22963-5307
Country	:	US
Telephone Number	:	434-842-1404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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