DERICK WADE CUNNINGHAM LMT NPI 1942594437

NPI Information

NPI: 1942594437
Provider Name: DERICK WADE CUNNINGHAM, LMT
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
3001 W WEDINGTON DR
APT 73
FAYETTEVILLE, AR
ZIP 72701
Phone: (870) 284-4029
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Derick Wade Cunningham, LMT is a massage therapist in Fayetteville, AR. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Derick Wade Cunningham, LMT NPI is 1942594437. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3001 W WEDINGTON DR
APT 73
FAYETTEVILLE, AR
ZIP 72701-528
Phone: (870) 284-4029

The enumeration date for this NPI number is 6/2/2011 and was last updated on 6/2/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		6977	ARKANSAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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