Provider Demographics
NPI:1164632493
Name:RIDGEWAY, SUZANNE E (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:E
Last Name:RIDGEWAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SUZANNE
Other - Middle Name:E
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:3957 RUTH COURT
Mailing Address - Street 2:
Mailing Address - City:MCFARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558
Mailing Address - Country:US
Mailing Address - Phone:608-838-8879
Mailing Address - Fax:
Practice Address - Street 1:814 JACKSON ST
Practice Address - Street 2:NAZARETH HEALTH & REHAB CENTER
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589
Practice Address - Country:US
Practice Address - Phone:608-873-6448
Practice Address - Fax:608-646-0497
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4692024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist