Individual
MR. KELLY CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
400 N 7TH ST, MARIETTA, OH 45750-2024
(740) 373-3597
Mailing address
107 PINEVIEW DR, MARIETTA, OH 45750-6703
(740) 373-3597
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0601586
OH
Other
Enumeration date
07/05/2007
Last updated
07/08/2007
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