Provider Demographics
NPI:1598718421
Name:DRISKELL, CYNTHIA (PT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:DRISKELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5924
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-5924
Mailing Address - Country:US
Mailing Address - Phone:480-488-9095
Mailing Address - Fax:480-488-2862
Practice Address - Street 1:100 EASY ST
Practice Address - Street 2:SUITE B
Practice Address - City:CAREFREE
Practice Address - State:AZ
Practice Address - Zip Code:85377-9600
Practice Address - Country:US
Practice Address - Phone:480-488-9095
Practice Address - Fax:480-488-2862
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ921225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ62202Medicare ID - Type Unspecified