Individual
SUSAN K NORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
263 CENTER ST, RANDOLPH, WI 53956-1409
(920) 326-5691
Mailing address
263 CENTER ST, RANDOLPH, WI 53956-1409
(920) 326-5691
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
497-019
WI
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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