Provider Demographics
NPI:1477543791
Name:STRIEBECK, SUSAN P (DC/PTA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:P
Last Name:STRIEBECK
Suffix:
Gender:F
Credentials:DC/PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 VINYARD RD
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:VA
Mailing Address - Zip Code:24179-3632
Mailing Address - Country:US
Mailing Address - Phone:540-343-0466
Mailing Address - Fax:540-345-2261
Practice Address - Street 1:1110 VINYARD RD
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:VA
Practice Address - Zip Code:24179-3632
Practice Address - Country:US
Practice Address - Phone:540-343-0466
Practice Address - Fax:540-345-2261
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555828111N00000X
VA2306601850225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant