MEDICARE: SUSAN E ORESHACK DPT

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	2251S0007X	Sports Physical Therapist
2	2251X0800X	Orthopedic Physical Therapist
3	225100000X	Physical Therapist	11131	AZ

General Provider Information

NPI Number	:	1568862696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN E ORESHACK DPT

Provider Business Mailing Address
First Line	:	4715 N 32ND ST
Second Line	:	SUITE 108
City	:	PHOENIX
State	:	AZ
Zip	:	85018-3300
Country	:	US
Telephone Number	:	480-689-5520
Fax Number	:	480-706-7409

Provider Business Practice Location Address
First Line	:	11225 N 28TH DR STE F100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5606
Country	:	US
Telephone Number	:	602-866-0066
Fax Number	:

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

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	12/25/2023

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Directions to “ SUSAN E ORESHACK DPT” Practice Location

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