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NPI Code Detail

MEDICARE: MRS. CYNTHIA WITHROW RPT

MEDICARE: MRS. CYNTHIA WITHROW RPT
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
1225100000XPhysical Therapist05002214AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000093122OTHERINANTHEM PIN
2200644210OTHERINFIRST STEPS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770660516
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA WITHROW RPT
Provider Business Mailing Address
First Line : 1595 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-2389
Country : US
Telephone Number : 219-764-4888
Fax Number : 219-898-4258
Provider Business Practice Location Address
First Line : 1595 S CALUMET RD STE 3
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-2389
Country : US
Telephone Number : 219-764-4888
Fax Number : 219-898-4258
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 08/27/2024

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Directions to “ MRS. CYNTHIA WITHROW RPT” Practice Location

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