Individual
SIOBHAN GRACE CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
825 GREEN VALLEY DR, PHILADELPHIA, PA 19128-1010
(215) 279-2863
Mailing address
825 GREEN VALLEY DR, PHILADELPHIA, PA 19128-1010
(215) 279-2863
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
01/27/2019
Last updated
01/08/2022
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