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NPI Code Detail

MEDICARE: MRS. CAROL SUSY FALLON PT

MEDICARE: MRS. CAROL SUSY FALLON PT
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
1225100000XPhysical Therapist3021OH

General Provider Information

NPI Number : 1295151462
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROL SUSY FALLON PT
Provider Business Mailing Address
First Line : 3035 WOOSTER RD
Second Line :
City : ROCKY RIVER
State : OH
Zip : 44116-4144
Country : US
Telephone Number : 440-356-9103
Fax Number :
Provider Business Practice Location Address
First Line : 3035 WOOSTER RD
Second Line :
City : ROCKY RIVER
State : OH
Zip : 44116-4144
Country : US
Telephone Number : 440-356-9103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2014
Last Update Date : 03/17/2014

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Directions to “ MRS. CAROL SUSY FALLON PT” Practice Location

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