MEDICARE: CYNTHIA MARIE VANDERS PT

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	225100000X	Physical Therapist	PTL.0002541	CO

General Provider Information

NPI Number	:	1225862733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA MARIE VANDERS PT

Provider Business Mailing Address
First Line	:	2218 PALM DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-7826
Country	:	US
Telephone Number	:	719-650-0943
Fax Number	:

Provider Business Practice Location Address
First Line	:	2735 N ARCADIA ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6330
Country	:	US
Telephone Number	:	719-259-7028
Fax Number	:	719-257-9709

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

Provider Enumeration Date	:	08/27/2024
Last Update Date	:	08/27/2024

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