Provider Demographics
NPI:1972045946
Name:FISHER, SUZANNE (MPT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-1147
Mailing Address - Country:US
Mailing Address - Phone:724-887-0100
Mailing Address - Fax:
Practice Address - Street 1:900 PORTER AVE
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683-1147
Practice Address - Country:US
Practice Address - Phone:724-887-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012168L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist