Provider Demographics
NPI:1891039319
Name:STESSMAN, CYNTHIA LUCILLE (PT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LUCILLE
Last Name:STESSMAN
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 1:1109 NORMAL ST
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:IA
Mailing Address - Zip Code:51579-1091
Mailing Address - Country:US
Mailing Address - Phone:712-647-2361
Mailing Address - Fax:712-647-2482
Practice Address - Street 1:1109 NORMAL ST
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:IA
Practice Address - Zip Code:51579-1091
Practice Address - Country:US
Practice Address - Phone:712-647-2361
Practice Address - Fax:712-647-2482
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0182225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist