| NPI | 1003063645 |
|---|---|
| Former Name | SUSAN KAY DOLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist Pediatrics (Licence: MD 16312) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: CA 12152) |
| 2251P0200X Physical Therapist Pediatrics (Licence: MI 5501001231) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2008-08-26 |