Provider Demographics
NPI:1851316301
Name:RICE, SUSAN M (PT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:RICE
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 1:586 SHEPARD ST
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-3552
Mailing Address - Country:US
Mailing Address - Phone:715-365-5252
Mailing Address - Fax:715-365-5252
Practice Address - Street 1:2600 RIB MOUNTAIN DR
Practice Address - Street 2:SUITE 220
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7148
Practice Address - Country:US
Practice Address - Phone:715-843-5300
Practice Address - Fax:715-843-5329
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2803024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist