Provider Demographics
NPI:1346454436
Name:GUNSELMAN, CYNTHIA A (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:GUNSELMAN
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 1:914 S 22ND ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-4914
Mailing Address - Country:US
Mailing Address - Phone:707-152-9558
Mailing Address - Fax:
Practice Address - Street 1:914 S 22ND ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-4914
Practice Address - Country:US
Practice Address - Phone:707-152-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR408225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116059721Medicaid
AR5R563OtherAR BCBS