Individual
MR. JOHN J SUSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
147 HOMESTEAD AVE, DEBARY, FL 32713-3875
(386) 668-1156
(386) 668-2256
Mailing address
PO BOX 530241, DEBARY, FL 32753-0241
(386) 668-1156
(386) 668-2256
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 15708
FL
Other
Enumeration date
06/26/2008
Last updated
07/08/2010
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