| NPI | 1659308559 |
|---|---|
| Former Name | SUSAN L YOUNGQUIST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12120024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070012149) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2015-12-05 |