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1912450560
JACOB CUNNINGHAM
PORTAGE, IN
NPI
1912450560
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IN 06004290A)
Enumeration Date
2016-08-01
Last Update Date
2016-08-01
Business Address
JACOB CUNNINGHAM
6459 US HIGHWAY 6
PORTAGE, IN 46368-5109
Phone number: 219-762-5592
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Mailing Address
JACOB CUNNINGHAM
790 REMINGTON BLVD
BOLINGBROOK, IL 60440-4909
Phone number: 630-296-2223
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