Basic Information
Provider Information
NPI: 1033312137
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAVIES
FirstName: SUSAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1901 11TH ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 559023429
CountryCode: US
TelephoneNumber: 5072521888
FaxNumber: 5072524711
Practice Location
Address1: 245 CAHABA VALLEY PKWY
Address2: SUITE 200
City: PELHAM
State: AL
PostalCode: 351242216
CountryCode: US
TelephoneNumber: 2059426820
FaxNumber: 2059425627
Other Information
ProviderEnumerationDate: 06/06/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTH2265ALY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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