Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 3639 | MA |
NPI | 1134735434 |
---|---|
Provider Name | Susan Francoeur |
First Address | Salem, NH 03079-4804 |
Second Address | Amesbury, MA 01913-2139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2020 |
Last Update Date | 22/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3639 | PHYSICAL THERAPY LICENSE (01) | MA |