Provider Demographics
NPI:1578516753
Name:DEVRIES, CYNTHIA K (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:K
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:K
Other - Last Name:FINKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7551 9TH ST N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-6629
Mailing Address - Country:US
Mailing Address - Phone:651-748-4338
Mailing Address - Fax:651-748-2892
Practice Address - Street 1:14000 NICOLLET AVE STE 110
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-5734
Practice Address - Country:US
Practice Address - Phone:952-892-6777
Practice Address - Fax:952-892-0792
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN650000217Medicare ID - Type UnspecifiedPART B