Provider Demographics
NPI:1750794368
Name:WEHRING, SUSAN P (EDD, LAT, ATC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:P
Last Name:WEHRING
Suffix:
Gender:F
Credentials:EDD, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 COLLEGE CHASE DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-5339
Mailing Address - Country:US
Mailing Address - Phone:813-836-4056
Mailing Address - Fax:
Practice Address - Street 1:816 COLLEGE CHASE DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-5339
Practice Address - Country:US
Practice Address - Phone:813-836-4056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2019-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110395542255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer