Provider Demographics
NPI:1386286409
Name:GALLOWAY, SUSAN LYNN (PT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNN
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:DONLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8625 TORONTO CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3260
Mailing Address - Country:US
Mailing Address - Phone:440-714-5119
Mailing Address - Fax:
Practice Address - Street 1:7685 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4216
Practice Address - Country:US
Practice Address - Phone:513-231-2700
Practice Address - Fax:512-231-2666
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT009753225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist