Provider Demographics
NPI:1487462040
Name:LEFTWICH, CYNTHIA CHILDRESS
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:CHILDRESS
Last Name:LEFTWICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 LAKELAND CT
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-2080
Mailing Address - Country:US
Mailing Address - Phone:540-222-5959
Mailing Address - Fax:
Practice Address - Street 1:12425 VILLAGE LOOP
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4306
Practice Address - Country:US
Practice Address - Phone:540-321-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306604840225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant