Susan M Blum, P.T.

Individual provider Active NPI Pediatric Physical Therapist · Windsor, PA

NPI 1760680680 · NPPES record last updated Mar 21, 2008

Key facts

NPI
1760680680
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Physical Therapist 2251P0200X
License
PT-001868-E (PA)
Practice address
140 Azalea Dr
Windsor, PA 17366-8518
Phone
(717) 309-1354
Fax
(717) 235-3531
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT-001868-EPAMDPediatric Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT-001868-E PA Yes

Addresses

Primary practice location

140 Azalea Dr
Windsor, PA 17366-8518

Mailing address

140 Azalea Dr
Windsor, PA 17366-8518
Phone (717) 309-1354

Other providers in Windsor, PA

All providers in Windsor, PA · Pediatric Physical Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.