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General NPI Number Information
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NPI Number | 1063962108
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Entity Type | Individual
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Provider Name | SUZAN RHEAULT
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Gender | Female
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Dates
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Enumeration Date | 10/13/2016
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 2 KEEWAYDIN DR
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City | SALEM
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State | NH
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Zip | 03079-2839
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Country | US
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Telephone | 800-955-6273
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Fax | 888-979-6551
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Provider Business Mailing Address
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Address Line | 2 KEEWAYDIN DR
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City | SALEM
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State | NH
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Zip | 03079-2839
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Country | US
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Telephone | 800-955-6273
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Fax | 888-979-6551
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PHYP1707
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTP-PT-LIC-6221
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7015
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-1966
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6023715
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License Number State | WA
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