Individual
SUSAN MCALLISTER BANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
6938 JOCKEY CLUB LN, HAYMARKET, VA 20169-2961
(703) 753-5519
Mailing address
6938 JOCKEY CLUB LN, HAYMARKET, VA 20169-2961
(703) 753-5519
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001412
VA
Other
Enumeration date
03/30/2013
Last updated
03/30/2013
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