Individual
NATHAN DANIEL CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
270 BU DR, BUCKHANNON, WV 26201-9689
(304) 472-3720
Mailing address
44 SEDGWICK ST, BUCKHANNON, WV 26201-2760
(304) 542-8099
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
C1A142300246
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00500638227
—
WV
Enumeration date
09/20/2019
Last updated
09/20/2019
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