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NPI Code Detail

MEDICARE: MRS. SUZANNE ATCAVAGE MPT

MEDICARE: MRS. SUZANNE ATCAVAGE 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 TherapistPT008472LPA

General Provider Information

NPI Number : 1871565390
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUZANNE ATCAVAGE MPT
Provider Business Mailing Address
First Line : 97 BEECH GROVE RD
Second Line :
City : HONESDALE
State : PA
Zip : 18431-4164
Country : US
Telephone Number : 570-253-5615
Fax Number :
Provider Business Practice Location Address
First Line : 354 MAIN ST
Second Line :
City : FOREST CITY
State : PA
Zip : 18421-1418
Country : US
Telephone Number : 570-785-2018
Fax Number : 570-785-3575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 06/29/2010

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Directions to “ MRS. SUZANNE ATCAVAGE MPT” Practice Location

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