Healthcare Provider Details

I. General information

NPI: 1558707653
Provider Name (Legal Business Name): SUSAN LYNN MASTURZO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2013
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SPRINGSIDE DR STE 107A
AKRON OH
44333-4509
US

IV. Provider business mailing address

150 SPRINGSIDE DR STE 107A
AKRON OH
44333-4509
US

V. Phone/Fax

Practice location:
  • Phone: 330-269-9336
  • Fax: 330-576-3330
Mailing address:
  • Phone: 330-269-9336
  • Fax: 330-576-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number04632
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: