Provider Demographics
NPI:1528238649
Name:BARROS, SUSAN SHOGREN (PT)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SHOGREN
Last Name:BARROS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 EAST ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2253
Mailing Address - Country:US
Mailing Address - Phone:508-543-1410
Mailing Address - Fax:
Practice Address - Street 1:164 EAST ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2253
Practice Address - Country:US
Practice Address - Phone:508-543-1410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist