Individual
CHASE SUSKO
Active
Individual
CHASE SUSKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT019621
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
394508
MEDICARE
PA
Enumeration date
06/17/2010
Last updated
06/17/2010
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