Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2985 | CO |
NPI | 1003159435 |
---|---|
Provider Name | Susan E Mclaughlin |
First Address | Bayfield, CO 81122-9370 |
Second Address | Bayfield, CO 81122-9370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2013 |
Last Update Date | 19/12/2016 |