Individual
SUSAN JEANNE LAW-GODAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
4701 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1219
(505) 727-4628
(503) 358-9083
Mailing address
2916 MONTEREY AVE SE, ALBUQUERQUE, NM 87106-2943
(503) 358-9083
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5104
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5104
STATE LICENSE
NM
Enumeration date
09/20/2017
Last updated
09/20/2017
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