Individual
SUSAN GRACE MCDIARMID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
751 OLD RICHARDSON HWY, #202, FAIRBANKS, AK 99701
(907) 455-4401
(907) 455-4402
Mailing address
FILE 50469, LOS ANGELES, CA 90074-0469
(530) 778-0200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1392
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1392
PT LICENCE #
AK
Enumeration date
05/20/2006
Last updated
07/08/2007
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