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General NPI Number Information
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NPI Number | 1659497063
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Entity Type | Individual
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Provider Name | SUZANNE L MCCOLGAN PTA
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 349 HAYDENVILLE RD
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City | LEEDS
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State | MA
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Zip | 01053-9767
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Country | US
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Telephone | 413-586-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 125 POMEROY MEADOW RD
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City | SOUTHAMPTON
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State | MA
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Zip | 01073-9331
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Country | US
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Telephone | 413-527-2568
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 3855
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License Number State | MA
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