Provider Demographics
NPI:1245450170
Name:GILMAN, SUZANNE CRANE (PT)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:CRANE
Last Name:GILMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 NORTHWAY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-2037
Mailing Address - Country:US
Mailing Address - Phone:508-429-4786
Mailing Address - Fax:774-233-0009
Practice Address - Street 1:909 SUMNER ST
Practice Address - Street 2:GODDARD REHAB.
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3396
Practice Address - Country:US
Practice Address - Phone:781-297-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist