Provider Demographics
NPI:1154568426
Name:MORGAN-SMITH, SUSAN L (LMT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:MORGAN-SMITH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 N PAUL RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4849
Mailing Address - Country:US
Mailing Address - Phone:850-566-0468
Mailing Address - Fax:
Practice Address - Street 1:1725 CAPITAL CIR NE STE 303
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0596
Practice Address - Country:US
Practice Address - Phone:850-329-6327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55217225700000X
FLMA 55217172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist