Provider Demographics
NPI:1508247974
Name:DEUTSCH, SUSAN JILLAYNE (PT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JILLAYNE
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7313 W 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-8870
Mailing Address - Country:US
Mailing Address - Phone:605-695-1321
Mailing Address - Fax:
Practice Address - Street 1:7313 W 65TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-8870
Practice Address - Country:US
Practice Address - Phone:605-695-1321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist