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Individual
SUSAN M. FITZPATRICK
Active
Individual
SUSAN M. FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5397
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
392626639000
BLUE CROSS BLUE SHIELD
WI
05
—
40366600
—
WI
Enumeration date
07/06/2006
Last updated
07/08/2007
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