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General NPI Number Information
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NPI Number | 1760507180
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Entity Type | Individual
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Provider Name | CYNTHIA S CREIGHTON OTR
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2107 CAMBRIDGE DR APT C
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City | GOSHEN
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State | IN
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Zip | 46528-5703
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Country | US
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Telephone | 574-202-6640
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Fax | 574-534-8733
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Provider Business Mailing Address
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Address Line | PO BOX 2902
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City | ELKHART
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State | IN
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Zip | 46515-2902
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Country | US
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Telephone | 574-202-6640
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Fax | 574-534-8733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 31000164A
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License Number State | IN
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