Individual
SUSAN K BERARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
405 E. 10TH, DILL CITY, OK 73641-0111
(580) 450-2500
Mailing address
PO BOX 111, DILL CITY, OK 73641-0111
(580) 450-2500
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2941
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT2941
PHYSICAL THERAPY LICENSE
OK
Enumeration date
05/15/2007
Last updated
07/08/2007
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