| NPI | 1689940777 |
|---|---|
| Former Name | SUSAN ROEPKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06004960A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 160.005856) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2015-02-25 |