Provider Demographics
NPI:1467852087
Name:GARZA, CYNTHIA RENE (LMT)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:RENE
Last Name:GARZA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 RICHFIELD TRL
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-5146
Mailing Address - Country:US
Mailing Address - Phone:312-617-9357
Mailing Address - Fax:
Practice Address - Street 1:849 S RIDGE RD
Practice Address - Street 2:
Practice Address - City:MINOOKA
Practice Address - State:IL
Practice Address - Zip Code:60447-8807
Practice Address - Country:US
Practice Address - Phone:815-467-5223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.005128225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist