Healthcare Provider Details

I. General information

NPI: 1053236687
Provider Name (Legal Business Name): SUSAN FAITH WASON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 CALEF HWY UNIT 11
EPPING NH
03042-2367
US

IV. Provider business mailing address

285 CALEF HWY UNIT 11
EPPING NH
03042-2367
US

V. Phone/Fax

Practice location:
  • Phone: 603-341-4921
  • Fax: 603-679-8177
Mailing address:
  • Phone: 603-341-4921
  • Fax: 603-679-8177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6283
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: