Provider Demographics
NPI:1427105782
Name:BELL, SUSANNE M (ATC)
Entity type:Individual
Prefix:
First Name:SUSANNE
Middle Name:M
Last Name:BELL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:28618 SPRING ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2873
Mailing Address - Country:US
Mailing Address - Phone:248-557-4997
Mailing Address - Fax:
Practice Address - Street 1:1001 N SILVERY LN
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1544
Practice Address - Country:US
Practice Address - Phone:423-284-3195
Practice Address - Fax:313-562-9361
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer