Provider Demographics
NPI:1275213928
Name:AGUILLON, SUZANNA JOY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:SUZANNA
Middle Name:JOY
Last Name:AGUILLON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SUZANNA
Other - Middle Name:JOY
Other - Last Name:BUCKINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2744 HAYSTACK BLVD APT 228
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-3579
Mailing Address - Country:US
Mailing Address - Phone:817-996-4223
Mailing Address - Fax:
Practice Address - Street 1:965 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5845
Practice Address - Country:US
Practice Address - Phone:817-594-7636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist