Provider Demographics
NPI:1780033985
Name:CUMMINGS, DAVID JOEL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOEL
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-0949
Mailing Address - Country:US
Mailing Address - Phone:904-261-4664
Mailing Address - Fax:904-261-5852
Practice Address - Street 1:1897 ISLAND WALK WAY STE 5
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-1949
Practice Address - Country:US
Practice Address - Phone:904-261-4664
Practice Address - Fax:904-261-5852
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1274526225100000X
FLPT38559225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist