Provider Demographics
NPI:1417016213
Name:LOAR, CINDY LEE (OTR)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:LEE
Last Name:LOAR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 PUMPHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5177
Mailing Address - Country:US
Mailing Address - Phone:706-651-0204
Mailing Address - Fax:
Practice Address - Street 1:4405 EVANS TO LOCKS RD STE C
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3603
Practice Address - Country:US
Practice Address - Phone:706-854-1598
Practice Address - Fax:706-854-8136
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA401225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist