Individual
SUSAN BULLARD STATON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
728 ACCREE EDMUNDSON RD, SCOTLAND NECK, NC 27874-8564
(252) 826-2099
Mailing address
728 ACCREE EDMUNDSON RD, SCOTLAND NECK, NC 27874-8564
(252) 826-2099
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
6171
NC
Other
Enumeration date
05/12/2006
Last updated
07/08/2007
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