Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 10565-024 | WI |
N | 2251X0800X | Physical Therapist - Orthopedic | 10565-024 | WI |
NPI | 1023046232 |
---|---|
Provider Name | Mrs. Susan Elizabeth Hardel |
First Address | Madison, WI 53716-1392 |
Second Address | Madison, WI 53716-1392 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 02/11/2020 |