Provider Demographics
NPI:1265480560
Name:CROKE, SUSIE L (PT, CSCS)
Entity Type:Individual
Prefix:MS
First Name:SUSIE
Middle Name:L
Last Name:CROKE
Suffix:
Gender:F
Credentials:PT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 SANTA FE DR
Mailing Address - Street 2:STE 120
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5143
Mailing Address - Country:US
Mailing Address - Phone:760-942-4400
Mailing Address - Fax:
Practice Address - Street 1:332 SANTA FE DR
Practice Address - Street 2:STE 120
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5143
Practice Address - Country:US
Practice Address - Phone:760-942-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist