Provider Demographics
NPI:1063686731
Name:PLANT, CYNTHIA ANNA (PT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANNA
Last Name:PLANT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 SPRING DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5594
Mailing Address - Country:US
Mailing Address - Phone:262-789-1452
Mailing Address - Fax:
Practice Address - Street 1:1520 SPRING DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5594
Practice Address - Country:US
Practice Address - Phone:262-789-1452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist