Provider Demographics
NPI:1427278324
Name:SUMMERS, CINDY S (LMT)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:S
Last Name:SUMMERS
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 1:231 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-9394
Mailing Address - Country:US
Mailing Address - Phone:304-366-7736
Mailing Address - Fax:
Practice Address - Street 1:2304 SMITHTOWN RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-2318
Practice Address - Country:US
Practice Address - Phone:304-216-9025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1999-0244225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist