Provider Demographics
NPI:1033263637
Name:BESSEY, SUSAN P (PT, PCS)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:P
Last Name:BESSEY
Suffix:
Gender:F
Credentials:PT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8257 TRADD CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-7297
Mailing Address - Country:US
Mailing Address - Phone:704-575-2670
Mailing Address - Fax:704-553-7587
Practice Address - Street 1:8257 TRADD CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-7297
Practice Address - Country:US
Practice Address - Phone:704-575-2670
Practice Address - Fax:704-553-7587
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC40032251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC721041GMedicaid
NC0004526411OtherAETNA
NC0796NOtherBLUE CROSS BLUE SHIELD
NCD3557OtherMEDCOST