Provider Demographics
NPI:1104039932
Name:ALCANTARA CIPRIANO, MARIA CECILIA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CECILIA
Last Name:ALCANTARA CIPRIANO
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 1:2552 POPLAR AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112
Mailing Address - Country:US
Mailing Address - Phone:901-323-1196
Mailing Address - Fax:901-323-1197
Practice Address - Street 1:2552 POPLAR AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112
Practice Address - Country:US
Practice Address - Phone:901-323-1196
Practice Address - Fax:901-323-1197
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000004399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist