Provider Demographics
NPI:1093412637
Name:HAMMOND, SUZANNE CHARLOTTE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:CHARLOTTE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:SUZANNE
Other - Middle Name:CHARLOTTE
Other - Last Name:DOUGALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 CASCADE RD
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-9000
Mailing Address - Country:US
Mailing Address - Phone:207-284-5700
Mailing Address - Fax:
Practice Address - Street 1:4 CASCADE RD
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-9000
Practice Address - Country:US
Practice Address - Phone:207-284-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT6352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist