Provider Demographics
NPI:1942684451
Name:GERBER, SUSAN LYNN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNN
Last Name:GERBER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:LYNN
Other - Last Name:OTTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1855 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2325
Mailing Address - Country:US
Mailing Address - Phone:303-926-3849
Mailing Address - Fax:303-604-6573
Practice Address - Street 1:1855 PLAZA DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2325
Practice Address - Country:US
Practice Address - Phone:303-926-3849
Practice Address - Fax:303-604-6573
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist