Individual
MRS. SUSAN AMY SPEICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7119 MAPLE LN, HORACE, ND 58047-4714
(701) 281-1864
(701) 281-1924
Mailing address
1636 WINSLOW CT, WEST FARGO, ND 58078-4041
(701) 282-6094
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1164
ND
2251P0200X
Pediatric Physical Therapist
6605
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27585
BLUE CROSS BLUE SHIELD
ND
05
—
51398
—
ND
Enumeration date
01/08/2007
Last updated
07/08/2007
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