Provider Demographics
NPI:1720111529
Name:CUNNINGHAM, STEVE ALAN (PT)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:ALAN
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7213 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8602
Mailing Address - Country:US
Mailing Address - Phone:970-576-1681
Mailing Address - Fax:
Practice Address - Street 1:1019 37TH AVENUE CT
Practice Address - Street 2:UNIT 2
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2566
Practice Address - Country:US
Practice Address - Phone:970-576-1681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7483225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist