MEDICARE: SUSAN ANN LARKIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305002595	VA

General Provider Information

NPI Number	:	1194248740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN ANN LARKIN

Provider Business Mailing Address
First Line	:	103 CURLES CIR
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-1409
Country	:	US
Telephone Number	:	757-229-0717
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 WILLIAMSBURG LANDING DR
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-8064
Country	:	US
Telephone Number	:	800-554-5517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2017
Last Update Date	:	07/25/2017

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Directions to “ SUSAN ANN LARKIN ” Practice Location

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