Individual
TARA LOUISE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.P
Contact information
Practice address
109 SECOND ST W, RAINIER, WA 98576
(360) 955-0060
Mailing address
PO BOX 851, RAINIER, WA 98576-0851
(360) 955-0060
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA 60129897
WA
Other
Enumeration date
06/30/2010
Last updated
06/30/2010
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