Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5501010982 | MI |
NPI | 1003037045 |
---|---|
Provider Name | Susannah Szeidel |
First Address | Burton, MI 48519-1455 |
Second Address | Auburn Hills, MI 48326-2569 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 27/09/2007 |