Individual
MRS. SUSAN C MATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
438 BASHORE DR, MARTINSBURG, WV 25404-7603
(304) 546-6020
Mailing address
438 BASHORE DR, MARTINSBURG, WV 25404-7603
(304) 546-6020
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
360
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156211000
—
WV
Enumeration date
04/20/2007
Last updated
04/07/2008
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