Provider Demographics
NPI:1811081615
Name:BLACKWELL, CINDY (PT)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:
Last Name:BLACKWELL
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 1:406 N 1ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1358
Mailing Address - Country:US
Mailing Address - Phone:812-885-2770
Mailing Address - Fax:812-886-4958
Practice Address - Street 1:406 N 1ST ST STE B
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1358
Practice Address - Country:US
Practice Address - Phone:812-885-2770
Practice Address - Fax:812-886-4958
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007240A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist