Provider Demographics
NPI:1972012946
Name:PELZER, SUZANNE IRENE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:IRENE
Last Name:PELZER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 GUTHRIE AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-1613
Mailing Address - Country:US
Mailing Address - Phone:319-331-2435
Mailing Address - Fax:
Practice Address - Street 1:4614 84TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-1089
Practice Address - Country:US
Practice Address - Phone:515-270-6838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083651225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist