Provider Demographics
NPI:1285974782
Name:BERRY, SUZANNE (DPT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BERRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 OAK ST
Mailing Address - Street 2:REBOUND PHYSICAL THERAPY
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1001
Mailing Address - Country:US
Mailing Address - Phone:508-651-0051
Mailing Address - Fax:508-651-0061
Practice Address - Street 1:203 OAK ST
Practice Address - Street 2:REBOUND PHYSICAL THERAPY
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1001
Practice Address - Country:US
Practice Address - Phone:508-651-0051
Practice Address - Fax:508-651-0061
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033240225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist