MEDICARE: CINDY KAY FIEGENBAUM CPTA

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	225200000X	Physical Therapy Assistant	14-00321	KS

General Provider Information

NPI Number	:	1629162284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY KAY FIEGENBAUM CPTA

Provider Business Mailing Address
First Line	:	500 SUNSET COURT
Second Line	:
City	:	DODGE CITY
State	:	KS
Zip	:	67801-7404
Country	:	US
Telephone Number	:	620-225-3907
Fax Number	:

Provider Business Practice Location Address
First Line	:	1909 N. 14TH STREET, SUITE C
Second Line	:
City	:	DODGE CITY
State	:	KS
Zip	:	67801-2364
Country	:	US
Telephone Number	:	620-338-8633
Fax Number	:	620-338-8121

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/05/2013

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