Individual
MISS SUSAN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
301 SICOMAC AVE, WYCKOFF, NJ 07481-2159
(201) 848-4323
Mailing address
20 STEVENS DR, DUMONT, NJ 07628-1022
(201) 385-0594
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00208900
NJ
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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