Healthcare Provider Details

I. General information

NPI: 1073608717
Provider Name (Legal Business Name): SUSAN ELIZABETH GREENWOOD M.S. , P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 OLENTANGY RIVER RD STE 100
COLUMBUS OH
43235-1353
US

IV. Provider business mailing address

170 TAYLOR STATION RD
COLUMBUS OH
43213-4441
US

V. Phone/Fax

Practice location:
  • Phone: 614-841-3900
  • Fax: 614-545-7901
Mailing address:
  • Phone: 614-545-7900
  • Fax: 614-545-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number014165
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6410
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0002231
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017370
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: