Provider Demographics
NPI:1265550735
Name:HARTMANN HURT, CYNTHIA LEE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LEE
Last Name:HARTMANN HURT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11460 FLAGG RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PORT WING
Mailing Address - State:WI
Mailing Address - Zip Code:54865-5706
Mailing Address - Country:US
Mailing Address - Phone:715-774-3528
Mailing Address - Fax:
Practice Address - Street 1:COOPER WEISBERG SCHOOL
Practice Address - Street 2:1807 MISSOURI AVE.
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-2225
Practice Address - Country:US
Practice Address - Phone:715-394-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1869-024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1869-024OtherPT STATE LICNSE NUMBER