Provider Demographics
NPI:1790037406
Name:WESTMORELAND, SUSAN (CMT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:WESTMORELAND
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E PORTER AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-9110
Mailing Address - Country:US
Mailing Address - Phone:219-926-8405
Mailing Address - Fax:
Practice Address - Street 1:751 E PORTER AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-9110
Practice Address - Country:US
Practice Address - Phone:219-926-8405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist