Provider Demographics
NPI:1083799084
Name:EMMER, SUSAN C (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:EMMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-0112
Mailing Address - Country:US
Mailing Address - Phone:781-383-1330
Mailing Address - Fax:781-383-6815
Practice Address - Street 1:7 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-1925
Practice Address - Country:US
Practice Address - Phone:781-383-1330
Practice Address - Fax:781-383-6815
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA911111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35739Medicare ID - Type UnspecifiedCHIROPRACTOR