Provider Demographics
NPI:1841318235
Name:BLUHM, SUSANA MARIA (DPT DOCTORATE PHYSIC)
Entity type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:MARIA
Last Name:BLUHM
Suffix:
Gender:F
Credentials:DPT DOCTORATE PHYSIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SKIPSTONE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677
Mailing Address - Country:US
Mailing Address - Phone:706-310-1627
Mailing Address - Fax:706-310-1627
Practice Address - Street 1:1077 BAXTER ST
Practice Address - Street 2:BABIES CANT WAIT EARLY INTERVENTION
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-369-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0083542251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics