MEDICARE: SUSAN W SEGERMAN P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	PT10897	OH
2	2251X0800X	Orthopedic Physical Therapist	PT002956	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063417210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN W SEGERMAN P.T.

Provider Business Mailing Address
First Line	:	8311 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2227
Country	:	US
Telephone Number	:	513-985-3700
Fax Number	:	513-985-3706

Provider Business Practice Location Address
First Line	:	8311 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2227
Country	:	US
Telephone Number	:	513-985-3700
Fax Number	:	513-985-3706

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	01/14/2010

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