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NPI Code Detail

MEDICARE: SUZANNE L KOLE MPT

MEDICARE: SUZANNE L KOLE MPT
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 Therapist2035NV
2225100000XPhysical TherapistPT009186GA
3225100000XPhysical Therapist6789SC

General Provider Information

NPI Number : 1437199080
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE L KOLE MPT
Provider Business Mailing Address
First Line : 3869 HIGHWAY 81 SOUTH
Second Line :
City : LOGANVILLE
State : GA
Zip : 30052-3918
Country : US
Telephone Number : 678-635-8280
Fax Number : 678-635-8285
Provider Business Practice Location Address
First Line : 3869 HIGHWAY 81 SOUTH
Second Line :
City : LOGANVILLE
State : GA
Zip : 30052-3918
Country : US
Telephone Number : 678-635-8280
Fax Number : 678-635-8285
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 10/10/2016

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Directions to “ SUZANNE L KOLE MPT” Practice Location

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