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NPI Code Detail

MEDICARE: SUSAN J RYERSON P.T., SCD

MEDICARE: SUSAN J RYERSON P.T., SCD
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
12251N0400XNeurology Physical Therapist2305000926VA

General Provider Information

NPI Number : 1881872521
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN J RYERSON P.T., SCD
Provider Business Mailing Address
First Line : 410 S MAPLE AVE
Second Line : SUITE 102
City : FALLS CHURCH
State : VA
Zip : 22046-4246
Country : US
Telephone Number : 703-370-2970
Fax Number :
Provider Business Practice Location Address
First Line : 410 S MAPLE AVE
Second Line : SUITE 102
City : FALLS CHURCH
State : VA
Zip : 22046-4246
Country : US
Telephone Number : 703-370-2970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2008
Last Update Date : 11/15/2016

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