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General NPI Number Information
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NPI Number | 1083866495
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Entity Type | Individual
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Provider Name | SUSAN B RABOURN P. T.
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Gender | Female
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 245 CROSSROADS BLVD
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City | CARMEL
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State | CA
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Zip | 93923-8650
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Country | US
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Telephone | 831-620-0744
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Fax | 831-620-0711
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Provider Business Mailing Address
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Address Line | PO BOX 222300
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City | CARMEL
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State | CA
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Zip | 93922-2300
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Country | US
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Telephone | 831-659-1946
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Fax |
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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 | PT 34988
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | PT 34988
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License Number State | CA
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