Provider Demographics
NPI:1174868343
Name:GURLEY, SUSAN S (DPT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:S
Last Name:GURLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:L
Other - Last Name:SCHERZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:328 THOMAS MORE PKWY
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3488
Mailing Address - Country:US
Mailing Address - Phone:513-347-9999
Mailing Address - Fax:859-344-4153
Practice Address - Street 1:328 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3488
Practice Address - Country:US
Practice Address - Phone:513-347-9999
Practice Address - Fax:859-344-4153
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006142225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK077530Medicare PIN
OHH239720Medicare PIN