Provider Demographics
NPI:1780750604
Name:STORM, CYNTHIA M (PT)
Entity type:Individual
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First Name:CYNTHIA
Middle Name:M
Last Name:STORM
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:310 PENN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2044
Mailing Address - Country:US
Mailing Address - Phone:814-695-2923
Mailing Address - Fax:814-695-2924
Practice Address - Street 1:119 FOLLMAR LN
Practice Address - Street 2:SUITE A
Practice Address - City:ALUM BANK
Practice Address - State:PA
Practice Address - Zip Code:15521-8262
Practice Address - Country:US
Practice Address - Phone:814-839-2783
Practice Address - Fax:814-839-2876
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2013-10-10
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Provider Licenses
StateLicense IDTaxonomies
PAPT005356L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ09396Medicare UPIN
PA076937KAOMedicare ID - Type UnspecifiedMEDICARE#