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Individual
SUSAN M. POWROZNIK
Active
Individual
SUSAN M. POWROZNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0016104
CO
225100000X
Physical Therapist
1300752
TX
225100000X
Physical Therapist
Primary
2305209951
VA
225100000X
Physical Therapist
4738
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154794659
MEDICAID QMB PROVIDER ID
VA
01
—
C05954
MEDICARE GROUP PTAN
VA
Enumeration date
11/05/2015
Last updated
10/19/2020
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