Individual
SUSAN CALLOWAY WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTDPTPCS
Contact information
Practice address
536 STANLEY AVE, ROCKINGHAM, NC 28379-3034
(910) 895-8174
Mailing address
536 STANLEY AVE, ROCKINGHAM, NC 28379-3034
(910) 895-8174
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1898
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079NH
BCBS IDENTIFICATION NUMBE
NC
05
—
3403400
—
NC
01
—
562033116
TRICARE-TAX ID
NC
Enumeration date
01/25/2007
Last updated
11/03/2008
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