Individual
SUSAN AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 CORPORATE DR, SUITE 2, BANGOR, ME 04401-4312
(207) 992-9286
(207) 992-9287
Mailing address
PO BOX 921, BANGOR, ME 04402-0921
(207) 942-7650
(207) 990-5586
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2565
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261630099
—
ME
Enumeration date
09/28/2006
Last updated
01/21/2009
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