Provider Demographics
NPI:1013128461
Name:HOSHI, SUSAN REIKO (PT, MSA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:REIKO
Last Name:HOSHI
Suffix:
Gender:F
Credentials:PT, MSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CHARLESTON CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7800
Mailing Address - Country:US
Mailing Address - Phone:540-659-6736
Mailing Address - Fax:540-741-1543
Practice Address - Street 1:1201 SAM PERRY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4490
Practice Address - Country:US
Practice Address - Phone:549-741-1545
Practice Address - Fax:540-741-1543
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6883225100000X
VA4250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist