Provider Demographics
NPI:1598744609
Name:HILLIARD, SUSAN L (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:HILLIARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:L
Other - Last Name:TOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:301 1ST ST
Mailing Address - Street 2:SUITE100
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4756
Mailing Address - Country:US
Mailing Address - Phone:724-282-4764
Mailing Address - Fax:724-282-6624
Practice Address - Street 1:301 1ST ST
Practice Address - Street 2:SUITE100
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4756
Practice Address - Country:US
Practice Address - Phone:724-282-4764
Practice Address - Fax:724-282-6624
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT003952L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA456125HBGMedicare ID - Type Unspecified