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Individual

SUSANN WISSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
154 S LIVINGSTON AVE, SUITE 204, LIVINGSTON, NJ 07039-3017
(973) 229-6627
Mailing address
51 WASHINGTON AVE, WEST CALDWELL, NJ 07006-7703
(973) 229-6627

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
40QA00657200
NJ

Other

Enumeration date
10/27/2010
Last updated
09/17/2012
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