Individual
MRS. SUSAN SHEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2842
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269708
—
OR
01
—
297215
OMAP
OR
05
—
297215
—
OR
01
—
838414000
BCBS
OR
01
—
R194433
MEDICARE
OR
Enumeration date
04/04/2006
Last updated
07/21/2022
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