Individual
SUSIE A CUSACK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
110 W COUNTRY CLUB RD, ROSWELL, NM 88201-0618
(505) 623-2292
(505) 623-2255
Mailing address
110 W COUNTRY CLUB RD, ROSWELL, NM 88201-0618
(505) 623-2292
(505) 623-2255
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3210
NM
Other
Enumeration date
05/17/2006
Last updated
07/08/2007
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