Individual
CYNTHIA DIANE HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MS, OCS
Contact information
Practice address
165 NATCHEZ TRACE AVE STE 200, BOWLING GREEN, KY 42103-7947
(270) 796-4698
(270) 782-3274
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1742
(270) 796-4698
(270) 782-3274
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003058
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000314785
ANTHEM PROVIDER NUMBER
KY
01
—
611273988
FACILITY TAX ID
KY
Enumeration date
12/27/2006
Last updated
01/04/2019
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