Provider Demographics
NPI:1831424167
Name:AUSTIN MOBLEY, CYNTHIA (LMT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:AUSTIN MOBLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 SW SWEETBAY CT
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32024-0738
Mailing Address - Country:US
Mailing Address - Phone:850-510-9857
Mailing Address - Fax:
Practice Address - Street 1:122 SW SWEETBAY CT
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32024-0738
Practice Address - Country:US
Practice Address - Phone:850-510-9857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 54087225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist