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Individual
SUSAN KOO
Active
Individual
SUSAN KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT16296
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT0162960
—
CA
Enumeration date
08/12/2006
Last updated
07/29/2015
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