| Doctor Name: | MRS. SUSAN MAXWELL |
| NPI Number: | 1609031061 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 11618-24 |
| Business Practice Address: | 7610 Pershing Blvd Kenosha, WI - 531424318 |
| Business Phone Number: | 2629483600 |
| Business Fax Number: | 2629483690 |
| Mailing Address: | 8561 S Ventana Dr, Apt 4517 OAK CREEK |
| State: | WI |
| Postal Code: | 531548343 |
| Phone Number: | 4148611202 |
| Fax Number: | |
| NPI Enumeration Date: | 07/25/2008 |
| NPI Last Update Date: | 05/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 11618-24 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |