Individual
SUSAN C MILLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4309 CLOUD DANCE, SANTA FE, NM 87507-2591
(505) 438-2960
(505) 438-2960
Mailing address
PO BOX 517, ARROYO HONDO, NM 87513-0517
(505) 776-1213
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1977
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B-3589
—
NM
Enumeration date
02/20/2007
Last updated
07/09/2007
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