Provider Demographics
NPI:1174661292
Name:LACOUTURE, CYNTHIA (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LACOUTURE
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:PO BOX 466
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-0466
Mailing Address - Country:US
Mailing Address - Phone:860-693-6226
Mailing Address - Fax:860-693-8002
Practice Address - Street 1:201 NORTH MOUNTAIN RD.
Practice Address - Street 2:SUITE 301
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062
Practice Address - Country:US
Practice Address - Phone:860-348-9338
Practice Address - Fax:860-348-9466
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist