Provider Demographics
NPI:1790962751
Name:HOWARD, SUSAN C (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:C
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 21ST ST SW
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912-1569
Mailing Address - Country:US
Mailing Address - Phone:507-437-6796
Mailing Address - Fax:
Practice Address - Street 1:107 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LAKE MILLS
Practice Address - State:IA
Practice Address - Zip Code:50450-1310
Practice Address - Country:US
Practice Address - Phone:641-592-3500
Practice Address - Fax:641-592-3502
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist