Provider Demographics
NPI:1639491277
Name:CAESAR, SUZANNE ELIZABETH (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:CAESAR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:SUZANNE
Other - Middle Name:ELIZABETH
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:606 BANK ST.
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:OH
Mailing Address - Zip Code:44254-1012
Mailing Address - Country:US
Mailing Address - Phone:216-577-2950
Mailing Address - Fax:
Practice Address - Street 1:10 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:OH
Practice Address - Zip Code:44287-0033
Practice Address - Country:US
Practice Address - Phone:216-577-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.016596225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist