Provider Demographics
NPI:1487196978
Name:ROZZI, SUSAN (ATC, SCAT)
Entity Type:Individual
Prefix:PROF
First Name:SUSAN
Middle Name:
Last Name:ROZZI
Suffix:
Gender:F
Credentials:ATC, SCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 MOSSY OAK WAY
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7807
Mailing Address - Country:US
Mailing Address - Phone:843-953-7163
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF HEALTH AND HUMAN PERFORMANCE
Practice Address - Street 2:COLLEGE OF CHARLESTON
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29424-0001
Practice Address - Country:US
Practice Address - Phone:843-953-7163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer