Individual
MRS. SUSAN LOUISE VICKERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2263 623RD AVE, ALBIA, IA 52531-8660
(641) 932-1673
(641) 932-1708
Mailing address
2263 623RD AVE, ALBIA, IA 52531-8660
(641) 932-1673
(641) 932-1708
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
01389
IA
Other
Enumeration date
03/17/2007
Last updated
07/08/2007
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