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Individual

SUSAN WELLIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
62 EDISON PARK, QUINCY, MA 02169-5627
(617) 479-1939

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7440
MA

Other

Enumeration date
03/22/2015
Last updated
03/22/2015
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