Provider Demographics
NPI:1417257437
Name:TYREE, CINDY (LMT)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:
Last Name:TYREE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 E PRATT STREET
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031-1241
Mailing Address - Country:US
Mailing Address - Phone:614-783-1864
Mailing Address - Fax:
Practice Address - Street 1:82 E PRATT STREET
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43031-1241
Practice Address - Country:US
Practice Address - Phone:614-783-1864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.17700225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist