Individual
SUSAN ANTRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2801 EVANS AVE, VALPARAISO, IN 46383-6940
(219) 464-9621
Mailing address
601 POST ST, WANATAH, IN 46390-9581
(708) 257-7893
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
160.005856
IL
225200000X
Physical Therapy Assistant
Primary
06004960A
IN
Other
Enumeration date
03/22/2012
Last updated
02/25/2015
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