Provider Demographics
NPI:1659730950
Name:SCHUPP, CYNTHIA LOU (PTA)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LOU
Last Name:SCHUPP
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 US HWY 27S
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870
Mailing Address - Country:US
Mailing Address - Phone:863-471-1223
Mailing Address - Fax:
Practice Address - Street 1:6120 US HWY 27S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-1221
Practice Address - Country:US
Practice Address - Phone:863-471-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA26428225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant