Provider Demographics
NPI:1184747941
Name:RADCLIFFE, SUSAN P (PTA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:P
Last Name:RADCLIFFE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 233
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-0233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 SNOW RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03470-2806
Practice Address - Country:US
Practice Address - Phone:603-239-6355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHEL31842225200000X
NH0535225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant