Susan Adele Davis, P.T.
Individual provider Active NPI Physical Therapist · River Falls, WI
NPI 1811039043 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1811039043
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 6460-024 (WI)
- Practice address
- 1629 E Division St
River Falls, WI 54022-1571 - Phone
- (715) 426-4537
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6460-024 | WI | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6460-024 | WI | Yes |
Addresses
Primary practice location
1629 E Division St
River Falls, WI 54022-1571
Mailing address
296 Edgewood Dr
Hudson, WI 54016-7109
Phone (715) 381-6524
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36106000 | Medicaid | WI |
Other providers in River Falls, WI
- Jennifer Kristen Crim
- Vincent James Crispino
- Rita Lynn Cudd
- Kelly Curtis
- James Scott Davis
- Laura K Decheine
- Paris Delisle
- Katherine J Delong-Hecker
- Daniel Dibenedetto
- Kate Dulaney
All providers in River Falls, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.