Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251X0800X | Physical Therapist - Orthopedic | PT002956 | KY |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT10897 | OH |
NPI | 1063417210 |
---|---|
Provider Name | Susan W Segerman |
First Address | Cincinnati, OH 45236-2227 |
Second Address | Cincinnati, OH 45236-2227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 14/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2526378 | (05) | OH |
87001277 | (05) | KY |