Provider Demographics
NPI:1568567048
Name:CLINTON, SUSAN C (PT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:CLINTON
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 1:400 BROAD ST.
Mailing Address - Street 2:STE 1006
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143
Mailing Address - Country:US
Mailing Address - Phone:412-259-5342
Mailing Address - Fax:412-259-5343
Practice Address - Street 1:400 BROAD ST.
Practice Address - Street 2:STE 1006
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143
Practice Address - Country:US
Practice Address - Phone:412-259-5342
Practice Address - Fax:412-259-5343
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist