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NPI Code Detail

MEDICARE: SUZANNE ELIZABETH PERRON

MEDICARE: SUZANNE ELIZABETH PERRON
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 Therapist05009558AIN

General Provider Information

NPI Number : 1366695215
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE ELIZABETH PERRON
Provider Business Mailing Address
First Line : 4625 E STOP 11 RD
Second Line : SUITE B
City : INDIANAPOLIS
State : IN
Zip : 46237-9101
Country : US
Telephone Number : 317-884-3383
Fax Number :
Provider Business Practice Location Address
First Line : 4625 E STOP 11 RD
Second Line : SUITE B
City : INDIANAPOLIS
State : IN
Zip : 46237-9101
Country : US
Telephone Number : 317-884-3383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2008
Last Update Date : 10/23/2008

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Directions to “ SUZANNE ELIZABETH PERRON ” Practice Location

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