| NPI | 1639333768 |
|---|---|
| Former Name | SUSAN CLAIRE RIESENBECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 006299) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 4018) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2011-11-21 |