Provider Demographics
NPI:1558415497
Name:DRUCKER, CYNTHIA CAROLYN (DC)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:CAROLYN
Last Name:DRUCKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:CAROLYN
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:302 HAPPY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-1536
Mailing Address - Country:US
Mailing Address - Phone:270-651-0221
Mailing Address - Fax:270-651-0441
Practice Address - Street 1:302 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1536
Practice Address - Country:US
Practice Address - Phone:270-651-0221
Practice Address - Fax:270-651-0441
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY671568OtherACN
11445259OtherCAQH
KY000000375852OtherBLUE CROSS BLUE SHIELD
KY85003887Medicaid
KY85003887Medicaid