Doctor Name: | MRS. SUSAN J NOWACK |
NPI Number: | 1962792283 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RPT |
License Number: | PT12905 |
Business Practice Address: | 17350 Vailetti Dr Sonoma, CA - 954763356 |
Business Phone Number: | 7079353230 |
Business Fax Number: | 7079358481 |
Mailing Address: | Po Box 1852, SONOMA |
State: | CA |
Postal Code: | 954761852 |
Phone Number: | 7079353230 |
Fax Number: | 7079358481 |
NPI Enumeration Date: | 04/08/2011 |
NPI Last Update Date: | 04/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT12905 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |