Provider Demographics
NPI:1790770683
Name:AFLAGUE, CYNTHIA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:AFLAGUE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2550
Mailing Address - Street 2:5281 FIELDCREST DR
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93011-2550
Mailing Address - Country:US
Mailing Address - Phone:805-482-9560
Mailing Address - Fax:805-482-9560
Practice Address - Street 1:2486 N PONDEROSA DR
Practice Address - Street 2:STE D106
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-2376
Practice Address - Country:US
Practice Address - Phone:805-484-5447
Practice Address - Fax:805-484-2158
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA15225225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist