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1164717039
MARC CLINTON CUNNINGHAM
PADUCAH, KY
NPI
1164717039
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center)
Enumeration Date
2011-06-18
Last Update Date
2011-06-18
Business Address
MARC CLINTON CUNNINGHAM
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number: 270-442-7121
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Mailing Address
MARC CLINTON CUNNINGHAM
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number:
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