Provider Demographics
NPI:1154566925
Name:WETZLER, SUSANNE LEE (PT)
Entity type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:LEE
Last Name:WETZLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SUSANNE
Other - Middle Name:LEE
Other - Last Name:JAGGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:926 LINDA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-6028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 BALTIMORE PIKE
Practice Address - Street 2:SUITE 301
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2852
Practice Address - Country:US
Practice Address - Phone:610-690-2520
Practice Address - Fax:610-690-4645
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009306L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist