MEDICARE: MS. CYNTHIA DRISKELL 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	921	AZ

General Provider Information

NPI Number	:	1598718421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA DRISKELL PT

Provider Business Mailing Address
First Line	:	PO BOX 5924
Second Line	:
City	:	CAREFREE
State	:	AZ
Zip	:	85377-5924
Country	:	US
Telephone Number	:	480-488-9095
Fax Number	:	480-488-2862

Provider Business Practice Location Address
First Line	:	100 EASY ST
Second Line	:	SUITE B
City	:	CAREFREE
State	:	AZ
Zip	:	85377-9600
Country	:	US
Telephone Number	:	480-488-9095
Fax Number	:	480-488-2862

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/08/2007

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