Provider Demographics
NPI:1881794394
Name:SCHUTT, CYNTHIA A (MS PT)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:A
Last Name:SCHUTT
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS PT ATC
Mailing Address - Street 1:937 NORTH OPDYKE ROAD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2641
Mailing Address - Country:US
Mailing Address - Phone:248-373-7600
Mailing Address - Fax:248-373-7443
Practice Address - Street 1:937 NORTH OPDYKE ROAD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2641
Practice Address - Country:US
Practice Address - Phone:248-373-7600
Practice Address - Fax:248-373-7443
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501006122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501006122OtherPHYSICAL THERAPIST