Provider Demographics
NPI:1114195252
Name:SWEENEY, SUSAN A (PT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:SWEENEY
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 1:1007 OLD STATE ROUTE 119
Mailing Address - Street 2:
Mailing Address - City:HUNKER
Mailing Address - State:PA
Mailing Address - Zip Code:15639-1231
Mailing Address - Country:US
Mailing Address - Phone:724-696-3261
Mailing Address - Fax:724-696-3248
Practice Address - Street 1:1007 OLD STATE ROUTE 119
Practice Address - Street 2:
Practice Address - City:HUNKER
Practice Address - State:PA
Practice Address - Zip Code:15639-1231
Practice Address - Country:US
Practice Address - Phone:724-696-3261
Practice Address - Fax:724-696-3248
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009614L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist