Organization
OH SUSANNAH
Active
Parent organization
OH SUSANNAH LLC
Other names
Physician Choice
Organization subpart
Yes
Provider details
NPI number
Legal business name
OH SUSANNAH LLC
Authorized official
MS. SUSAN L. MORELAND N/A (MEMBER)
(210) 386-2296
Entity
Organization
Contact information
Practice address
1100 NW LOOP 410, SUITE 700, SAN ANTONIO, TX 78213-2263
(210) 386-2296
(210) 828-3698
Mailing address
101 S SKIPPER DR, SAN ANTONIO, TX 78216-7446
(210) 386-2296
(210) 828-3698
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181471702
—
TX
Enumeration date
12/29/2008
Last updated
12/29/2008
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