Provider Demographics
NPI:1477970838
Name:WEHRLY, SUSAN (RMT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:WEHRLY
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12021 PENNSYLVANIA ST
Mailing Address - Street 2:#203
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12021 PENNSYLVANIA ST
Practice Address - Street 2:#203
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3150
Practice Address - Country:US
Practice Address - Phone:720-984-9822
Practice Address - Fax:303-450-1574
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0011993174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist