Provider Demographics
NPI:1235259300
Name:CUNNINGHAM, ASHLEY MCMILLAN (PT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MCMILLAN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PT
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4510 E CAMP LOWELL DR
Mailing Address - Street 2:STE 120
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1282
Mailing Address - Country:US
Mailing Address - Phone:520-320-7712
Mailing Address - Fax:520-320-7638
Practice Address - Street 1:16220 FREDERICK RD
Practice Address - Street 2:STE 120
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4039
Practice Address - Country:US
Practice Address - Phone:240-724-6781
Practice Address - Fax:888-607-7117
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ12714225100000X
GAPT008979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPT008979OtherLICENSE NUMBER
GAPT008979OtherLICENSE NUMBER