Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 10176 | NC |
NPI | 1073691291 |
---|---|
Provider Name | Ms. Suzanne Marie Sadusky |
First Address | Charlotte, NC 28207-1101 |
Second Address | Huntersville, NC 28078-7137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 11/07/2007 |