Individual
MS. ELLEN K CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1106 NE 9TH AVE, GAINESVILLE, FL 32601-4542
(352) 792-2016
Mailing address
1106 NE 9TH AVE, GAINESVILLE, FL 32601-4542
(352) 792-2016
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 45115
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C3892
BLUECROSS BLUESHIELD OF FLORIDA
FL
Enumeration date
06/02/2011
Last updated
06/02/2011
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