Provider Demographics
NPI:1528264520
Name:CYR, CAROL ANN (LMP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:CYR
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1126
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:WA
Mailing Address - Zip Code:98862-1126
Mailing Address - Country:US
Mailing Address - Phone:509-996-8102
Mailing Address - Fax:509-996-8102
Practice Address - Street 1:28 HILLSIDE LANE
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:WA
Practice Address - Zip Code:98862-1126
Practice Address - Country:US
Practice Address - Phone:509-996-8102
Practice Address - Fax:509-996-8102
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist