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Individual
MRS. SUSANNE WATSON BURNETT
Active
Individual
MRS. SUSANNE WATSON BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R. P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3952
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1741
P.T. LICENSE
SC
05
—
920042
—
AZ
Enumeration date
12/13/2006
Last updated
07/09/2007
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