Individual
SUSAN DIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
215 THATCHER ST, BROCKTON, MA 02302-3949
(508) 583-5834
Mailing address
433 W WATER ST, ROCKLAND, MA 02370-2452
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
8068
MA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT8068
MA
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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