| NPI | 1104024272 |
|---|---|
| Former Name | SUSAN M CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID ID PT 723) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00003302) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2007-07-10 |