Provider Demographics
NPI:1528216074
Name:FRANK, CYNTHIA J (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:FRANK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:J
Other - Last Name:JOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3832 E MAIN ST
Mailing Address - Street 2:UNITS E & F
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-8749
Mailing Address - Country:US
Mailing Address - Phone:505-564-2955
Mailing Address - Fax:505-564-2662
Practice Address - Street 1:3832 E MAIN ST
Practice Address - Street 2:UNITS E & F
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-8749
Practice Address - Country:US
Practice Address - Phone:505-564-2955
Practice Address - Fax:505-564-2662
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX320059Medicare Oscar/Certification