Healthcare Provider Details

I. General information

NPI: 1023260247
Provider Name (Legal Business Name): SUZANNE ELAINE DUGAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7855 S EMERSON AVE SUITE W
INDIANAPOLIS IN
46237-8668
US

IV. Provider business mailing address

8902 N MERIDIAN ST STE 215
INDIANAPOLIS IN
46260-5382
US

V. Phone/Fax

Practice location:
  • Phone: 317-889-5340
  • Fax: 317-889-5711
Mailing address:
  • Phone: 317-581-1890
  • Fax: 317-581-2436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: