MEDICARE: CYNTHIA M FLEENER 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	03446	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070.016074	OTHER	IL	ILLINOIS PT LICENSE NO.
2	03446	OTHER	IA	IOWA PT LICENSE NO.

General Provider Information

NPI Number	:	1114985751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA M FLEENER PT

Provider Business Mailing Address
First Line	:	4029 4TH STREET A
Second Line	:
City	:	EAST MOLINE
State	:	IL
Zip	:	61244-3442
Country	:	US
Telephone Number	:	309-737-2542
Fax Number	:	309-743-2073

Provider Business Practice Location Address
First Line	:	4029 4TH STREET A
Second Line	:
City	:	EAST MOLINE
State	:	IL
Zip	:	61244-3442
Country	:	US
Telephone Number	:	309-737-2542
Fax Number	:

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	09/28/2020

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