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General NPI Number Information
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NPI Number | 1023046232
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Entity Type | Individual
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Provider Name | SUSAN ELIZABETH HARDEL P.T., L.A.T
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Gender | Female
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 4901 COTTAGE GROVE RD
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City | MADISON
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State | WI
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Zip | 53716-1392
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Country | US
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Telephone | 608-221-1501
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Fax | 608-223-3540
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Provider Business Mailing Address
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Address Line | 4901 COTTAGE GROVE RD
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City | MADISON
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State | WI
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Zip | 53716-1392
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Country | US
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Telephone | 608-839-3531
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Fax | 608-223-3540
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 10565-024
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 10565-024
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License Number State | WI
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