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NPI Code Detail

MEDICARE: JULIA NICOLE SUYAK DPT

MEDICARE: JULIA NICOLE SUYAK DPT
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 Therapist5501019171MI
2225100000XPhysical Therapist13307SC

General Provider Information

NPI Number : 1942868385
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA NICOLE SUYAK DPT
Provider Business Mailing Address
First Line : 1434 W WEBSTER RD
Second Line :
City : ROYAL OAK
State : MI
Zip : 48073-3134
Country : US
Telephone Number : 734-934-6336
Fax Number :
Provider Business Practice Location Address
First Line : 1621 HIGHWAY 17 N
Second Line :
City : NORTH MYRTLE BEACH
State : SC
Zip : 29582-2229
Country : US
Telephone Number : 843-353-3460
Fax Number : 843-353-3461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2019
Last Update Date : 03/16/2026

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