Individual
MR. JEFFREY S SUSTAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1211 BERKELEY DR, RICHARDSON, TX 75081-5932
(903) 268-7675
Mailing address
1211 BERKELEY DR, RICHARDSON, TX 75081-5932
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2052028
TX
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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