Provider Demographics
NPI:1487775490
Name:GALVIN, SUZANNE L (PT, DPT)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:L
Last Name:GALVIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 W CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3714
Mailing Address - Country:US
Mailing Address - Phone:508-647-1633
Mailing Address - Fax:508-647-1634
Practice Address - Street 1:247 W CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3714
Practice Address - Country:US
Practice Address - Phone:508-647-1633
Practice Address - Fax:508-647-1634
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist