Provider Demographics
NPI:1366194276
Name:CUNNINGHAM, HALLE MCKENZIE (DPT)
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:MCKENZIE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26367 CONIFER RD
Mailing Address - Street 2:STE A
Mailing Address - City:ASPEN PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80433
Mailing Address - Country:US
Mailing Address - Phone:303-838-3900
Mailing Address - Fax:
Practice Address - Street 1:26367 CONIFER RD
Practice Address - Street 2:STE A
Practice Address - City:ASPEN PARK
Practice Address - State:CO
Practice Address - Zip Code:80433
Practice Address - Country:US
Practice Address - Phone:303-838-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008739225100000X
COCP038533T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist