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Individual
SUSAN SANFORD
Active
Individual
SUSAN SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT LIC ACC
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
215639
MA
225100000X
Physical Therapist
005094
CT
225100000X
Physical Therapist
Primary
10886
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y68186
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/03/2006
Last updated
02/14/2023
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