Provider Demographics
NPI:1760704589
Name:YARDUMIAN, CINDY (PTA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:YARDUMIAN
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 1:725 SUNRISE CIR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-7723
Mailing Address - Country:US
Mailing Address - Phone:719-687-8645
Mailing Address - Fax:
Practice Address - Street 1:615 SOUTHPOINTE CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3855
Practice Address - Country:US
Practice Address - Phone:719-579-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT 384225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant