Provider Demographics
NPI:1275507121
Name:PEEL, SUSAN M (ATC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:PEEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 WEBBER AVE
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48529-2416
Mailing Address - Country:US
Mailing Address - Phone:810-743-1177
Mailing Address - Fax:810-743-8152
Practice Address - Street 1:2100 E BRISTOL RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48552-0001
Practice Address - Country:US
Practice Address - Phone:810-236-9686
Practice Address - Fax:810-236-9602
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist