Provider Demographics
NPI:1235952219
Name:ARMSTRONG, SUSAN (PTA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 HALLMARK CT STE 2
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-6825
Mailing Address - Country:US
Mailing Address - Phone:989-992-2773
Mailing Address - Fax:
Practice Address - Street 1:3055 HALLMARK CT STE 2
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-6825
Practice Address - Country:US
Practice Address - Phone:989-992-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502000403225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant