MEDICARE: MRS. CYNTHIA L STANGL C.M.P.

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
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1225184484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA L STANGL C.M.P.

Provider Business Mailing Address
First Line	:	4626 15TH AVE SE
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56304
Country	:	US
Telephone Number	:	320-241-1017
Fax Number	:

Provider Business Practice Location Address
First Line	:	1747 7TH ST S
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56301-4047
Country	:	US
Telephone Number	:	320-251-0822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2007
Last Update Date	:	04/07/2014

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