Individual
CYNYRLYNNE LOLA SUGANOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1332 W ARCH HAVEN AVE STE E, BLOOMINGTON, IN 47403-2078
(812) 333-7018
(812) 333-7094
Mailing address
1455 W WESTWIND CT, BLOOMINGTON, IN 47403-8926
(812) 259-1442
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012864A
IN
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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