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NPI Code Detail

MEDICARE: LEROY CYNKAR

MEDICARE:   LEROY  CYNKAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Z00000XOrthotist
2224P00000XProsthetist

General Provider Information

NPI Number : 1083065494
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEROY CYNKAR
Provider Business Mailing Address
First Line : 1015 ROBERTSON ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3926
Country : US
Telephone Number : 970-231-1108
Fax Number : 970-419-8870
Provider Business Practice Location Address
First Line : 1015 ROBERTSON ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3926
Country : US
Telephone Number : 970-231-1108
Fax Number : 970-419-8870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2016
Last Update Date : 06/27/2016

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Directions to “ LEROY CYNKAR ” Practice Location

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