Provider Demographics
NPI:1952664310
Name:REENTS, CYNTHIA A (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:REENTS
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 1:2 DAYS SPRING LN
Mailing Address - Street 2:STREET LINE 2
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-4158
Mailing Address - Country:US
Mailing Address - Phone:217-299-0302
Mailing Address - Fax:
Practice Address - Street 1:1215 FRANCISCAN DR
Practice Address - Street 2:STREET LINE 2
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-1778
Practice Address - Country:US
Practice Address - Phone:217-324-8780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.005550225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist