Provider Demographics
NPI:1801388475
Name:KANTER, SUSANNE B (MSPT)
Entity Type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:B
Last Name:KANTER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23490 HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-3141
Mailing Address - Country:US
Mailing Address - Phone:612-888-9882
Mailing Address - Fax:
Practice Address - Street 1:23490 MN-7
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:MN
Practice Address - Zip Code:55331
Practice Address - Country:US
Practice Address - Phone:612-888-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6690225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist