Provider Demographics
NPI:1710002795
Name:RICE, CYNTHIA A (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:RICE
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 1:325 PINE BLVD
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-9604
Mailing Address - Country:US
Mailing Address - Phone:570-366-4630
Mailing Address - Fax:
Practice Address - Street 1:1000 ORWIGSBURG MANOR DR
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-1303
Practice Address - Country:US
Practice Address - Phone:570-621-7432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008266L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50039861OtherBLUE CROSS
PA0019260920002Medicaid
PA406873OtherHEALTH AMERICA HEALTH ASS
PARI1746221OtherBLUE SHIELD