Provider Demographics
NPI:1598090466
Name:MCDONALD, SUZANNE LOWE (PT)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:LOWE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:2627 COLUMBIA BLVD
Mailing Address - Street 2:BLOOMSBURG SPORTSPLEX
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-8831
Mailing Address - Country:US
Mailing Address - Phone:570-387-4815
Mailing Address - Fax:570-387-4852
Practice Address - Street 1:2627 COLUMBIA BLVD
Practice Address - Street 2:BLOOMSBURG SPORTSPLEX
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8831
Practice Address - Country:US
Practice Address - Phone:570-387-4815
Practice Address - Fax:570-387-4852
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT004001E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist