Provider Demographics
NPI:1629162284
Name:FIEGENBAUM, CINDY KAY (CPTA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:KAY
Last Name:FIEGENBAUM
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SUNSET COURT
Mailing Address - Street 2:
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-7404
Mailing Address - Country:US
Mailing Address - Phone:620-225-3907
Mailing Address - Fax:
Practice Address - Street 1:1909 N. 14TH STREET, SUITE C
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2364
Practice Address - Country:US
Practice Address - Phone:620-338-8633
Practice Address - Fax:620-338-8121
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00321225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant