Provider Demographics
NPI:1700373222
Name:KRUTSINGER, SUSAN (PT, DPT, CLT-LANA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:KRUTSINGER
Suffix:
Gender:F
Credentials:PT, DPT, CLT-LANA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 2ND STREET PIKE
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3822
Mailing Address - Country:US
Mailing Address - Phone:215-494-7353
Mailing Address - Fax:
Practice Address - Street 1:45 2ND STREET PIKE
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3822
Practice Address - Country:US
Practice Address - Phone:215-494-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008554L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist