Provider Demographics
NPI:1316674252
Name:SCHMIDT, CYNTHIA KAY (PTA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KAY
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:KAY
Other - Last Name:BRAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1051 HIGHWAY 46 S
Mailing Address - Street 2:
Mailing Address - City:VANLEER
Mailing Address - State:TN
Mailing Address - Zip Code:37181-6613
Mailing Address - Country:US
Mailing Address - Phone:931-627-9184
Mailing Address - Fax:
Practice Address - Street 1:198 HILLVIEW ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1285
Practice Address - Country:US
Practice Address - Phone:615-446-8159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8168225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant