Provider Demographics
NPI:1932702669
Name:CYR, CASSANDRA J (MS, ATC)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:J
Last Name:CYR
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:CYR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:21 MORIN AVE
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-1532
Mailing Address - Country:US
Mailing Address - Phone:603-303-6639
Mailing Address - Fax:
Practice Address - Street 1:229 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03435-0001
Practice Address - Country:US
Practice Address - Phone:603-358-2149
Practice Address - Fax:603-358-2888
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH14982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer