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Individual
SUSAN COOL
Active
Individual
SUSAN COOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2081-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014100
—
WI
05
—
11014110
—
WI
01
—
2081-24
LICENSE NUMBER
WI
01
—
390848401050
BLUE CROSS
WI
Enumeration date
04/08/2008
Last updated
05/24/2011
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