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General NPI Number Information
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NPI Number | 1346420924
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Entity Type | Organization
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Legal Business Name | SUSAN N PICK
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 493 LANTANA RD
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City | CROSSVILLE
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State | TN
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Zip | 38555-4946
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Country | US
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Telephone | 931-707-8383
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Fax | 931-707-1076
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Provider Business Mailing Address
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Address Line | PO BOX 568
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City | CROSSVILLE
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State | TN
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Zip | 38557-0568
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Country | US
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Telephone | 931-707-8383
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Fax | 931-707-1076
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Authorized Official
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Title or Position | SOLE OWNER
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Name | MRS. SUSAN N. PICK
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Credential | M.D.
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Telephone | 931-707-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 023765
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 023765
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License Number State | TN
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