Provider Demographics
NPI:1134289184
Name:SCHMIDT, CYNTHIA SMITH (BS PHYSICAL THERAPY)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:SMITH
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:BS PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 40TH AVE SOUTH
Mailing Address - Street 2:#F124
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-7294
Mailing Address - Country:US
Mailing Address - Phone:701-775-0025
Mailing Address - Fax:
Practice Address - Street 1:815 40TH AVE S
Practice Address - Street 2:#F124
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-7294
Practice Address - Country:US
Practice Address - Phone:701-775-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist