Doctor Name: | PATRICK CUNNINGHAM |
NPI Number: | 1003259136 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BUILDING CONTRACTOR |
License Number: | CBC059880 |
Business Practice Address: | 11595 Ne County Road 237 Lake Butler, FL - 320545235 |
Business Phone Number: | 3524942300 |
Business Fax Number: | |
Mailing Address: | 11595 Ne County Road 237, LAKE BUTLER |
State: | FL |
Postal Code: | 320545235 |
Phone Number: | 3524942300 |
Fax Number: | |
NPI Enumeration Date: | 04/08/2013 |
NPI Last Update Date: | 04/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | CBC059880 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |