Provider Demographics
NPI:1073948485
Name:PIRKL, SUSAN D (CMRMT, LMT, RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:D
Last Name:PIRKL
Suffix:
Gender:F
Credentials:CMRMT, LMT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 BETHEL RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2775
Mailing Address - Country:US
Mailing Address - Phone:614-273-0810
Mailing Address - Fax:614-273-0173
Practice Address - Street 1:1151 BETHEL RD
Practice Address - Street 2:SUITE 302
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2775
Practice Address - Country:US
Practice Address - Phone:614-273-0810
Practice Address - Fax:614-273-0173
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9292225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist