Provider Demographics
NPI:1659712297
Name:CUMMING, JOHN A (DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:CUMMING
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 1:1904 SKY PARK DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4735
Mailing Address - Country:US
Mailing Address - Phone:541-773-2999
Mailing Address - Fax:541-773-1874
Practice Address - Street 1:1904 SKY PARK DR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4735
Practice Address - Country:US
Practice Address - Phone:541-773-2999
Practice Address - Fax:541-773-1874
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR602802251X0800X
UT8611024-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic