Provider Demographics
NPI:1821237934
Name:WOOTERS, CYNTHIA RENEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:RENEE
Last Name:WOOTERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:509 N BRIGHTLEAF BLVD
Mailing Address - Street 2:REHAB SERVICES DEPARTMENT
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4407
Mailing Address - Country:US
Mailing Address - Phone:919-938-7296
Mailing Address - Fax:919-938-7078
Practice Address - Street 1:509 N BRIGHTLEAF BLVD
Practice Address - Street 2:REHAB SERVICES DEPARTMENT
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4407
Practice Address - Country:US
Practice Address - Phone:919-938-7296
Practice Address - Fax:919-938-7078
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist