Provider Demographics
NPI:1407158769
Name:CUNNINGHAM, DAVID SCOTT (DPT)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:966A PARK ST # A
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3650
Mailing Address - Country:US
Mailing Address - Phone:617-770-2224
Mailing Address - Fax:617-341-9328
Practice Address - Street 1:150 PARKINGWAY
Practice Address - Street 2:SUITE 2
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5058
Practice Address - Country:US
Practice Address - Phone:617-770-2224
Practice Address - Fax:617-847-6935
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist