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Individual

MS. SUSAN LYNNE RIVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
16825 TEQUESTA TRL, CLERMONT, FL 34715-9466
(321) 230-1951
Mailing address
16825 TEQUESTA TRL, CLERMONT, FL 34715-9466
(321) 230-1951

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PN552801
FL

Other

Enumeration date
12/24/2008
Last updated
12/24/2008
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