Provider Demographics
NPI:1861555476
Name:SENZON, SUSAN S (DC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:S
Last Name:SENZON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2570
Mailing Address - Country:US
Mailing Address - Phone:828-251-0815
Mailing Address - Fax:
Practice Address - Street 1:218 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2570
Practice Address - Country:US
Practice Address - Phone:828-251-0815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085MMOtherBC-BS
NC89085MMMedicaid
NC89085MMMedicaid