Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | RN269374 | OH |
N | 175F00000X | Naturopath | RN509068L | PA |
N | 175L00000X | Homeopath | RN269374 | OH |
N | 175L00000X | Homeopath | RN509068L | PA |
N | 225700000X | Massage Therapist | 20032345 | WV |
N | 225700000X | Massage Therapist | 308981-00 | PA |
NPI | 1508880311 |
---|---|
Provider Name | Ms. Susan Marina Perdos |
First Address | Canfield, OH 44406-9506 |
Second Address | Canfield, OH 44406-9506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |